{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:23:21Z","timestamp":1772990601014,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The development of acquired middle ear cholesteatoma is associated with a single nucleotide polymorphism, 538G&gt;A, in the human adenosine triphosphate\u2010binding cassette transporter C11 (\n                      <jats:italic>ABCC11<\/jats:italic>\n                      ) gene, which is a determinant of the earwax morphotype, such as wet\u2010 and dry\u2010type earwax; however, the mechanism underlying this association is unclear. We focused on the earwax pH and aimed to elucidate the mechanism between\n                      <jats:italic>ABCC11<\/jats:italic>\n                      genotypes and acquired middle ear cholesteatoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single\u2010center, academic hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We recruited 40 patients with acquired middle ear cholesteatoma who underwent surgery and 115 controls with no history of middle ear cholesteatoma. We assessed the earwax pH and\n                      <jats:italic>ABCC11<\/jats:italic>\n                      genotypes in all participants. Clinical information was collected from the patients with cholesteatoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The earwax pH was significantly less acidic in patients with cholesteatoma and those carrying wet earwax genotypes (\n                      <jats:italic>ABCC11<\/jats:italic>\n                      538G\/G or 538G\/A) than in the controls and those carrying the dry earwax genotype (\n                      <jats:italic>ABCC11<\/jats:italic>\n                      538A\/A), respectively. Furthermore, earwax pH was significantly positively correlated with high preoperative cholesteatoma stages in the patients with cholesteatoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our results show that the less acidic earwax pH was significantly related to the development and progression of acquired middle ear cholesteatoma. The less acidic earwax pH may play an important role in the mechanism underlying the association between acquired middle ear cholesteatoma and the\n                      <jats:italic>ABCC11<\/jats:italic>\n                      gene at site 538.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.888","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T04:57:42Z","timestamp":1719896262000},"page":"1511-1517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Reduced Acidic Earwax pH and Earwax\u2010Determinant Genotypes in Acquired Middle Ear Cholesteatoma"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5199-8363","authenticated-orcid":false,"given":"Satoshi","family":"Hara","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo Japan"},{"name":"Department of Molecular and Comparative Pathobiology Johns Hopkins University School of Medicine Baltimore Maryland USA"},{"name":"International Collaborative Research Administration Juntendo University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kusunoki","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Applied Biological Chemistry, Graduate School of Bioscience and Biotechnology Chubu University  Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazusaku","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The University of Tokyo Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Takata","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Juntendo University Faculty of Medicine Tokyo 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