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The association between middle ear diseases and metals serum levels in adult population is not well studied. So, the aim of this study was to estimate the serum levels of some metals (iron, magnesium, zinc and lead) in patients presented with chronic otitis media, and find if there is possible link with cholesteatoma formation or not. Patients and methods: This study was a across-sectional prospective study; conducted on 59 patients with chronic otitis media from ear, nose and throat department of Al-Azhar University Hospital (New Damietta) from January 2018 to December 2018 compared to the same number of age matched healthy controls. Serum iron, zinc, magnesium and lead levels were estimated to all patients and the healthy controls. Results: There was significant decrease of serum iron, magnesium and zinc while serum lead level was significantly increased in the patient’s group as compared to the healthy controls. Cholesteatoma was found in 18 (30.5%) of the patient’s group. There was significant decrease of magnesium and significant increase of lead concentrations in patients who developed cholesteatoma. In addition, at the lead cut off values of 10µg/dl, cholesteatoma was more common in patients with high lead concentration. Conclusions: The results of this study showed that there were significant differences among patients and control and groups according to the studied metals levels. Serum levels of magnesium lead may play a role in the development of cholesteatoma. Recommendation: It is recommended to measure at least magnesium and lead levels in chronic otitis media patients and to add lead chelating agents, antioxidant and anti-inflammatory drugs with the antibiotics for its treatment ,which could decrease free radical induced inflammatory alterations and prevent complications of otitis media. Further studies are required to ascertain the associations between the studied metals and the development of cholesteatoma.

Serum levels of Some metals (iron, magnesium, zinc and lead) in patients with chronic otitis media and its association with cholesteatoma formation