Middle ear and Eustachian tube lining in chronic otitis media

1978 ◽  
Vol 3 (4) ◽  
pp. 491-493 ◽  
Author(s):  
G. ZECHNER
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media

scholarly journals Comparative study between throat swab and ear discharge swabs culture and sensitivity findings in pediatric patients with bilateral chronic otitis media

2019 ◽  
Vol 5 (4) ◽  
pp. 932
Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P.
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Throat Swab ◽  
Chronic Otitis Media ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
The Common ◽  
Culture And Sensitivity

<p class="abstract"><strong>Background:</strong> Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.</p><p class="abstract"><strong>Methods:</strong> Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was <em>S. Aureus</em> followed by <em>Psuedomonas</em>. The ear swab and throat swab findings showed positive relationship (p&lt;0.05) for the common organisms i.e., <em>S. Aureus</em>, <em>pseudomonas</em> and <em>Streptococcus pyogenes</em> respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.</p><p class="abstract"><strong>Conclusions:</strong> The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.</p><p> </p>

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

scholarly journals Multiple Osteomas in Middle Ear

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Yongxin Li ◽  
Qiuhuan Li ◽  
Shusheng Gong ◽  
Honggang Liu ◽  
Zilong Yu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Semicircular Canal ◽  
Chronic Otitis Media ◽  
Lateral Semicircular Canal ◽  
Type Iii ◽  
One Stage ◽  
Tensor Tympani Muscle

Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009), and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage.

Characterization of mucins in human middle ear and Eustachian tube

2001 ◽  
Vol 280 (6) ◽  
pp. L1157-L1167 ◽  
Author(s):  
Jizhen Lin ◽  
Vladimir Tsuprun ◽  
Hirokazu Kawano ◽  
Michael M. Paparella ◽  
Zhiqiang Zhang ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Middle Ear Mucosa ◽  
Pathological Conditions ◽  
Mucin Expression ◽  
Mucin Genes ◽  
Human Middle Ear

Mucins are important glycoproteins in the mucociliary transport system of the middle ear and Eustachian tube. Little is known about mucin expression within this system under physiological and pathological conditions. This study demonstrated the expression of MUC5B, MUC5AC, MUC4, and MUC1 in the human Eustachian tube, whereas only MUC5B mucin expression was demonstrated in noninflamed middle ears. MUC5B and MUC4 mucin genes were upregulated 4.2- and 6-fold, respectively, in middle ears with chronic otitis media (COM) or mucoid otitis media (MOM). This upregulation of mucin genes was accompanied by an increase of MUC5B- and MUC4-producing cells in the middle ear mucosa. Electron microscopy of the secretions from COM and MOM showed the presence of chainlike polymeric mucin. These data indicate that the epithelium of the middle ear and Eustachian tube expresses distinct mucin profiles and that MUC5B and MUC4 mucins are highly produced and secreted in the diseased middle ear. These mucins may form thick mucous effusion in the middle ear cavity and compromise the function of the middle ear.

scholarly journals Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection

2015 ◽  
Vol 84 (1) ◽  
pp. 356-364 ◽  
Author(s):  
Takashi Hirano ◽  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Haemophilus Influenzae ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Murine Model ◽  
Chronic Otitis Media ◽  
Culture Positive

NontypeableHaemophilus influenzae(NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (107CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4+CD25+FoxP3+Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear.

Multiple Osteomas of Eustachian Tube Causing Ipsilateral Otitis Media

2020 ◽  
Vol 16 (8) ◽  
pp. 1052-1054
Author(s):  
Suzan Saylisoy
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Suture Line ◽  
Limited Data ◽  
Radiological Features ◽  
Middle Ear Ventilation ◽  
Basic Functions ◽  
Anatomical Area

Background: Middle ear ventilation and the drainage of secretions are the basic functions of the eustachian tube. Eustachian tube (ET) dysfunction can lead to otitis media. Multiple causes of ET dysfunction exist; ET obstruction is one of them. Osseous obliteration of ET is quite rare. In the literature, there are two cases of solitary osteoma and a case of hamartoma with an osseous content in the ET. Herein, this report describes the case of a patient with multiple osseous lesions consistent with osteomas in the ET, causing ipsilateral otitis media with CT findings. Case Report: A 53-year-old woman presented with left-sided intermittent otalgia and otorrhea. Temporal bone computed tomography showed opacification of middle ear consistent with otitis media and nearly complete blockage of the left ET lumen with multiple osseous lesions wall probably consistent with osteomas on the left side. Conclusion: There are limited data about the radiological features of ET osteoma due to its rare occurrence. Radiographically, external ear osteoma generally appears as a single pedunculated hyperdense mass on CT scan originating from the tympanosquamous or tympanomastoid suture line and extending into the auditory canal with otherwise preserved canal dimensions. Considering this information, osseous lesions arising from ET bone wall and extending into the lumen in the present case were considered as osteomas. Especially in the case of unilateral chronic otitis media, ET should not remain a neglected anatomical area.

Correlation of Tubal Function and Volume of Mastoid and Middle Ear Space as Related to Otitis Media

1976 ◽  
Vol 85 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Lars Andréasson
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Mucosal Damage ◽  
Cell System ◽  
Tubal Function ◽  
Functional Volume ◽  
Air Cells ◽  
Mastoid Air Cells

In 69 ears with chronic otitis media and nine ears with traumatic perforations tubal function, the size of the mastoid air cell system measured planimetrically on roentgenograms and the functional volume of the air filled ear spaces were studied for any correlations. The roentgenographic area and the functional volume were also studied for any variation in the duration of the disease. A correlation was found between abnormally small volumes and impaired tubal function, probably due to mucosal damage of the whole system, i.e. Eustachian tube, middle ear and mastoid air cells. No such association was found between area and tubal function. The volume, but not the area, decrease with the duration of the disease.

scholarly journals Assessment of eustachian tube dysfunction in middle ear pathologies

2018 ◽  
Vol 5 (1) ◽  
pp. 127
Author(s):  
T. Dinesh Singh ◽  
C. P. Sudheer
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Eustachian Tube Function ◽  
Auditory Tube ◽  
Postoperative Assessment ◽  
Tube Dysfunction ◽  
Tube Function

<p class="abstract"><strong>Background:</strong> Auditory tube dysfunction is suspected as primary cause of chronic otitis media and leads to surgical related complications in otitis media with tympanic membrane perforation. The diagnosis of eustachian tube malfunction is essential to know the pathogenesis of chronic otitis media.</p><p class="abstract"><strong>Methods:</strong> A total 150 cases and 75 age, sex matched control subjects between age group 20-50 years were selected. Pre and post-surgical history was noted and detailed ear examination, tympanometry was done. Auditory tube function was evaluated through Valsalva test, nasopharyngoscopy, pneumatic otoscopy. Intact tympanic membrane was assessed by Williams test, perforated tympanic membrane by Toynbee’s test.  </p><p class="abstract"><strong>Results:</strong> Postoperative assessment of eustachian tube function by Toynbee’s test for 19 cases with failed tympanoplasty showed normal ET function in 5 cases, 8 cases had partial and 6 cases had gross ET dysfunction. Postoperative assessment ET function by William’s test showed 4 cases among 19 cases had partial ET dysfunction and 01 cases had gross ET dysfunction.</p><p class="abstract"><strong>Conclusions:</strong> Efficient surgical outcome of middle ear complications always depends on eustachian tube function. Most of the cases with residual CP showed partial or gross ET dysfunction. Patients with tubal dysfunction should be evaluated for underlying cause and treatable causes should addressed before proceeding for surgery as it increases the success rate of tympanoplasty.</p>

EVALUATION OF MASTOID PATHOLOGY IN TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA

2020 ◽  
Vol VOLUME 8 (ISSUE 1) ◽  
pp. 30-34
Author(s):  
Sumit Sharma
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Age Groups ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Nasal Allergy ◽  
Suppurative Otitis Media ◽  
Number Of Factors ◽  
Tube Dysfunction

Otitis media is an in􀃸ammation of a part or whole of the mucoperiosteal lining of the middle ear cleft which is composed of Eustachian tube, h y p o t y m p a n u m , m e s o t y m p a n u m , epitympanum, aditus and mastoid air cells(1). It is one of the commonest ear disease of all age groups and it is caused by multiple interrelated factors including infections, eustachian tube dysfunction, nasal allergy and trauma. The disease has been classi􀃶ed on the basis of its underlying pathology as active or inactive mucosal, active or inactive squamosal and healed chronic otitis media (2). A number of factors are involved in the outcome of surgery for Chronic suppurative Otitis media and one of them is condition of the mastoid. According to Jackler and Schindler (3) Mastoid factors are extent of pneumatization and presence of in􀃸ammatory disease in mastoid. Holmquist and Bergstorm (4) in 1978 said that well aerated mastoid is a prerequisite for well ventilated middle ear and long lasting success. KEY WORDS: SAFE OTITIS MEDIA, MASTOIDECTOMY, MASTOID ANTRUM.

Histopathology of the Mucosa of Eustachian Tube Orifice at the Middle Ear in Chronic Otitis Media With Effusion: Possible Insight Into Tuboplasty Failure

2018 ◽  
Vol 127 (11) ◽  
pp. 817-822 ◽  
Author(s):  
Florian Christov ◽  
Michael B. Gluth
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Single Case ◽  
Balloon Dilation ◽  
Chronic Otitis Media ◽  
Normal Mucosa ◽  
The Status ◽  
Middle Ear Ventilation

Introduction: Balloon dilation of the cartilaginous segment of the Eustachian tube has emerged as a means to directly augment tubal dilatory function, and this has been applied as a potential treatment for otitis media with effusion (OME). Although results of clinical studies involving this modality appear promising, there are still a moderate number of ears affected by OME that do not respond. The purpose of this study was to investigate the status of mucosa of the Eustachian tube at the middle ear orifice in OME as it may relate to some cases of tuboplasty failure. Methods: Twenty-three temporal bone specimens with OME were identified within an institutional archived collection. Each specimen was inspected for the presence of a fixed obstruction at the level of the Eustachian tube orifice at the protympanum. In addition, the mucosa at the tubal orifice was graded on a 4-point scale. Results: Overall, 3 cases (13%) were normal (Grade 1), 6 cases (26%) were mildly thickened (Grade 2), 11 (48%) were severely thickened (Grade 3), and 3 (13%) were severely thickened with polypoid degeneration (Grade 4). A single case was noted to have a complete fixed obstruction in the form of a mucosal web. Conclusion: In ears affected by OME, the mucosa of the Eustachian tubal orifice at the middle ear is most often severely thickened. Normal mucosa, mucosa with severe polypoid changes, or a complete fixed obstruction are possible but uncommon. The majority of specimens studied had sufficiently diseased mucosa to raise questions regarding whether thickened mucosa in the tubal orifice may act as a barrier to middle ear ventilation that would not be directly addressed by cartilaginous Eustachian tube balloon dilation.

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