{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:17:57Z","timestamp":1790745477961,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,2,6]],"date-time":"2014-02-06T00:00:00Z","timestamp":1391644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review of case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of six patients who demonstrated melanin in the ear were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six patients from 1 to 63 years of age were identified with extracellular melanin and melanin\u2010laden histiocytes within the middle ear and\/or mastoid air cells at time of surgery. Concurrent intraoperative findings included cholesteatoma (n\u2009=\u20093), chronic suppurative otitis media (n\u2009=\u20092), and coalescent mastoiditis (n\u2009=\u20091). Histologically, extracellular melanin and melanin\u2010laden histiocytes were identified by Fontana\u2010Masson stain; absence of melanocytes was confirmed by the absence of Melan\u2010A staining. One patient had a positive stain for CD163 (a marker for macrophages).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 124:E241\u2013E244, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24507","type":"journal-article","created":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T10:06:29Z","timestamp":1383818789000},"source":"Crossref","is-referenced-by-count":5,"title":["Extracellular and intracellular melanin in inflammatory middle ear disease"],"prefix":"10.1002","volume":"124","author":[{"given":"Mark A.","family":"Fritz","sequence":"first","affiliation":[{"name":"Department of Otolaryngology New York University School of Medicine New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela C.","family":"Roehm","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology New York University School of Medicine New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Bannan","sequence":"additional","affiliation":[{"name":"Department of Pathology New York University School of Medicine New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil K.","family":"Lalwani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Columbia University College of Physicians and Surgeons, New York New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0749.1988.tb00421.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1982.00790560027007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1978.00790110052013"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(95)90007-1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198411000-00012"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100118195"},{"key":"e_1_2_6_8_1","first-page":"559","article-title":"[Malignant melanoma of the middle ear, a rare site]","volume":"50","author":"Urpegui Garcia A","year":"1999","journal-title":"Acta Otorrinolaringol Esp"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.9.1126"},{"key":"e_1_2_6_10_1","first-page":"83","article-title":"Primary malignant melanoma of the middle ear mucosa: a case report","volume":"16","author":"Ozturk O","year":"2006","journal-title":"Kulak Burun Bogaz Ihtis Derg"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-007-0022-5"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110002872"},{"key":"e_1_2_6_13_1","first-page":"291","article-title":"Melanocyte localization and distribution in human cholesteatoma","volume":"23","author":"Olszewska E","year":"2008","journal-title":"Histol Histopathol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0749.1992.tb00779.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(84)80028-9"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016488509108920"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-5955(85)90163-7"},{"key":"e_1_2_6_18_1","first-page":"522","article-title":"Augmentation of intraocular inflammation by melanin","volume":"33","author":"Kaya M","year":"1992","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.02556.x"},{"key":"e_1_2_6_20_1","first-page":"144","article-title":"Activation of the alternative complement pathway by fungal melanins","volume":"9","author":"Rosas AL","year":"2002","journal-title":"Clin Diagn Lab Immunol"},{"key":"e_1_2_6_21_1","first-page":"764","article-title":"Anti\u2010inflammatory and immunomodulating properties of grape melanin. 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