IL6 and cholesteatoma: Keratinocytes were found to secrete proinflammatory cytokines such as interleukin (IL)-1b, IL-6, and IL-8; these cytokines stimulate perimatrix fibroblasts to release other cytokines and proinflammatory factors, causing persistent inflammation in the middle ear, which might eventually lead to keratinocyte hyperproliferation and cholesteatoma development [55,56].