Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. The purpose of this study was to investigate HPVs in non-tumor middle ear diseases, including chronic otitis media (COM). Methods. COM specimens (n=52), including chronic suppurative otitis media (CSOM) (n=38) and cholesteatoma (COMC) (n=14), as well as normal middle ear specimens (NME) (n=56) were analyzed. HPV DNA sequences and DNA loads were analyzed by quantitative PCR. HPV genotyping was performed by direct sequencing of the amplimers. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) NME (p>0.05). Specifically, HPV DNA sequences were revealed in 26.3% (10/38) of CSOM and in 14.3% (2/14) COMC (p>.05). Interestingly, the HPV DNA load was higher in COMC (mean 7.47 copy/cell) than in CSOM (mean 1.02 copy/cell), and NME (mean 1.18 copy/cell) (P=.03 and P=.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. This data indicates that HPV-positive CSOM and COMC are generally associated with higher viral DNA loads as compared to NME. In addition, for the first time, HPVs were detected in normal middle ear mucosa specimens. This result suggests that NME is an additional epithelial tissue that can be HPV infected
