Comparison of acquired cholesteatoma between pediatric and adult patients

The quantification of angiogenesis and metalloproteinases may be useful in cholesteatoma behavior assessment as markers of its aggressiveness. The objective of this study is to compare markers CD31, MMP2 and MMP9 in pediatric and adult patients. This study is based on cross-sectional studies of pediatric (≤18 years old) and adult groups (≥19 years old). Samples of 120 cholesteatomas were fixed in 10% formol, prepared on five slides of each sample through habitual histological techniques, and number of blood vessels (CD31), marking with MMP2 and MMP9, number of matrix cells and thickness at perimatrix cell were observed. Data were analyzed through SPSS using Spearman and Mann–Whitney coefficients. Cholesteatomas were equally distributed: 60 in pediatric patients (11.77 ± 3.57 years); 60 in adult patients (38.29 ± 14.51 years). When correlating the number of blood vessels and metalloproteinases with perimatrix thickness, we obtained the following values: pediatric CD31, 7 (4–11); adult CD31, 4 (0–10) (P = 0.044); pediatric cytoplasmatic MMP2, 1 (0–3); adult cytoplasmatic MMP2, 0 (0–1) (P = 0.006); pediatric nuclear MMP2, 0 (0–1); adult nuclear MMP2, 0 (0–1) (P = 0.056); pediatric MMP9, 2 (0–4); adult MMP9, 0 (0–4) (P = 0.049). In conclusion, pediatric cholesteatomas present a more exacerbated inflammatory degree, produce more metalloproteinases, factors that, when combined, could characterize pediatric cholesteatomas as more aggressive than adult cholesteatomas.