Inhibition of cholesteatomatous bone resorption with pamidronate disodium.

Bone destruction is known to be an important cause of complications in chronic cholesteatomatous otitis media. A strategy that blocks localized bone resorption may prevent the progression of the disease. The bisphosphonate drug pamidronate is known to inhibit bone resorption and has been used in the treatment of Paget's disease and osteoporosis. The aim of this study was to investigate the effect of pamidronate on the inhibition of bone resorption in cholesteatoma using a neonatal rat calvarial culture system. Radioactive calcium was subcutaneously injected into pregnant rats. Neonatal calvariae were harvested after i.p. injection of pamidronate disodium to neonatal rats and culture supernatants of cholesteatoma keratinocytes were then added to the calvarial culture media. Radioactive calcium release was measured using a beta-ray scintillation counter. The percentage of calcium release was significantly higher in cholesteatoma culture supernatant than in Dulbecco's modification of Eagle's medium. The percentage calcium release in cholesteatoma culture supernatant was significantly lower with the high dose of pamidronate than with the low dose. These results suggest that pamidronate can inhibit the bone resorption caused by cholesteatoma. This study suggests a possible application for pamidronate in the prevention of cholesteatomatous bone destruction.