Document Detail


Extracellular and intracellular melanin in inflammatory middle ear disease.
MedLine Citation:
PMID:  24999501     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: Melanin is a pigmented polymer with a known role in dermal solar protection. In vertebrates, melanogenesis has been reported in leukocyte populations, suggesting a potential role in innate immunity. In this study, we report the novel finding of melanin associated with chronic inflammation and speculate on its potential role in the middle ear and mastoid.
STUDY DESIGN: Retrospective review of case series.
METHODS: Medical records of six patients who demonstrated melanin in the ear were reviewed.
RESULTS: Six patients from 1 to 63 years of age were identified with extracellular melanin and melanin-laden histiocytes within the middle ear and/or mastoid air cells at time of surgery. Concurrent intraoperative findings included cholesteatoma (n = 3), chronic suppurative otitis media (n = 2), and coalescent mastoiditis (n = 1). Histologically, extracellular melanin and melanin-laden histiocytes were identified by Fontana-Masson stain; absence of melanocytes was confirmed by the absence of Melan-A staining. One patient had a positive stain for CD163 (a marker for macrophages).
CONCLUSION: This case series is the first demonstration of melanin within middle ear mucosa without melanocytes in immediate proximity or metastatic melanocytic lesions. Melanin's presence in the setting of inflammation suggests that there may be a heretofore unreported link between the pigmentary and immune systems in the middle ear.
LEVEL OF EVIDENCE: 4.
Authors:
Mark A Fritz; Pamela C Roehm; Michael A Bannan; Anil K Lalwani
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  124     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-07-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E241-4     Citation Subset:  IM    
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