BASIC FIBROBLAST-GROWTH-FACTOR IN THE PERIMATRIX OF CHOLESTEATOMAS

The growth of a cholesteatoma requires angioneogenesis in the connecti ve tissue of the perimatrix. Angioneogenesis is also needed for wound healing as a host response to tissue injury. Normal wound repair is co nducted through a wide number of growth factors. Basic fibroblast grow th factor (b-FGF) plays a pivotal role in wound repair. This cytokine exerts its effects through stimulation of a wide range of target cells . B-FGF is chemotactic and mitogenic for fibroblasts, endothelial cell s and keratinocytes. In addition, b-FGF can stimulate the production o f collagenase and plasminogen activators to enhance fibroblast prolife ration and angioneogenesis. Its necessity for normal wound repair has been confirmed by several workers. Method: In order to demonstrate ang ioneogenesis in the cholesteatoma perimatrix the distribution of b-FGF as the pivotal cytokine of the process was investigated in the perima trix of 18 cholesteatoma specimens. Results: B-FGF could be observed i n 12 of 18 specimens (66%) in close approximation to histological sign s of inflammation and wound healing. Areas with b-FGF also exhibited p roliferation of the covering squamous epithelium. Cholesteatoma matrix tissue without inflammation or any sign of wound healing did not expr ess b-FGF (6 of 18). Conclusion: Histological changes and distribution pattern of b-FGF in the perimatrix of cholesteatoma in the present st udy indicate that the perimatrix cells and substances of the wound hea ling cascade may play an important role in cholesteatoma development, angiogenesis and growth.