Mucous Glands in the Middle Ear and Osseous Eustachian Tube

1973 ◽  
Vol 82 (1) ◽  
pp. 80-88 ◽  
Author(s):  
K. Bak-Pedersen ◽  
M. Tos
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Normal Component ◽  
Great Majority ◽  
Oval Window ◽  
Mastoid Process ◽  
Middle Ear Mucosa ◽  
Clinically Normal ◽  
The Individual ◽  
Temporal Bones

The mucous membranes from the osseous Eustachian tube, tympanic cavity, epitympanum, antrum, and mastoid process on clinically normal middle ears from 45 temporal bones were stained by the PAS-alcian blue whole-mount method and systematically studied for the presence, number, and density of mucous glands. Only four patients did not exhibit glands. The total number of glands in the individual patients amounted to less than 60 in 85% of the cases. Only two patients showed high counts, 273 and 337 glands, respectively. The mean density was 0.53 gland per mm2. In most of the patients the glands were found in three to six different localities, the most common locality being the oval window. Glands were found in only ten osseous Eustachian tubes, in very small numbers. By far the great majority of glands were inactive and degenerated. In ten patients, however, there was a small number of active glands. The glands demonstrated are presumably the sequelae of previous pathological actions upon the middle ear and Eustachian tube, and the glands are probably not a normal component of the middle ear mucosa.

Goblet Cell Population in the Normal Middle Ear and Eustachian Tube of Children and Adults

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 44-50 ◽  
Author(s):  
Mirko Tos ◽  
K. Bak-Pedersen
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Round Window ◽  
Newborn Infants ◽  
Lateral Wall ◽  
Goblet Cells ◽  
Oval Window ◽  
Mastoid Process ◽  
Temporal Bones ◽  
Age Range

On 54 temporal bones from entirely normal prematures and newborn infants, children, and adults, 30,000 to 90,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. In the Eustachian tube, normal prematures showed a very low density of goblet cells in all localities, increasing in the pharyngeal parts gradually through childhood and reaching in the normal adult a very high density in the pharyngeal orifice. There are no differences in density between the medial and lateral wall, but in some parts a decrease of density towards the tubal roof. In the middle ear the density is low in normal prematures, increasing slightly in infants, and decreasing again during the age range 7–14 years and in adults. Goblet cells are present in all middle-ear localities, but in markedly decreasing density in this sequence: hypotympanum anteriorly, posteriorly, promontory anteriorly, in the middle, epitympanum, niche of oval window, antrum, niche of round window, mastoid process, incus, and promontory posteriorly.

Distribution and Density of Goblet Cells in the Normal Adult Human Middle Ear

1973 ◽  
Vol 82 (2) ◽  
pp. 240-247 ◽  
Author(s):  
K. Bak-Pedersen ◽  
M. Tos
Keyword(s):  
Cell Density ◽  
Middle Ear ◽  
Goblet Cell ◽  
Anterior Part ◽  
Goblet Cells ◽  
Mastoid Process ◽  
Clinically Normal ◽  
Normal Series ◽  
Temporal Bones ◽  
Goblet Cell Density

The purpose of this study was to map the distribution and density of goblet cells in the clinically normal middle ear. From 12 temporal bones, derived from 12 adult patients with clinically normal middle ears, the mucosa was prepared and stained by the PAS-alcian blue whole-mount method. In six of the patients the middle ears with meticulous gross and microscopic investigation showed mild sequelae of previous otitis media, called the slightly abnormal series, whereas the other six patients who had entirely normal middle ears were designated the normal series. Each middle ear was investigated in 12 different areas: tympanic orifice, hypotympanum anteriorly and posteriorly, round window niche, oval window niche, promontory anteriorly, in the middle, and posteriorly, epitympanum, antrum, and mastoid process. In each middle ear area the goblet-cell density and distribution were determined on the basis of 30 to 50 counts of 0.01768 mm2 epithelial surface, a total of at least 4800 counts. In six patients goblet cells were found in all 12 areas, in three patients in 11, and in three patients in 10. In both series there was a distinct decrease in goblet-cell density from the tympanic orifice, towards the posterior areas of the middle ear and the mastoid process. However, two patients of the slightly abnormal series exhibited a considerably greater density in the posterior than in the anterior part of the hypotympanum. The mean goblet-cell density in the slightly abnormal series was distinctly greater in all middle ear areas than in the normal series. Correspondingly, goblet cells were demonstrated in the antrum and mastoid process in all patients of the slightly abnormal series, but in only half of the normal series. Therefore, the greater goblet-cell density in the slightly abnormal series presumaby results from a previous past disease condition of the middle ear.

Middle-Ear Mucosa in Newborn Infants

1974 ◽  
Vol 83 (2) ◽  
pp. 168-173 ◽  
Author(s):  
K. Bak-Pedersen ◽  
Mirko Tos
Keyword(s):  
Mucous Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Clinical Symptoms ◽  
Anterior Part ◽  
Normal Component ◽  
Newborn Infants ◽  
Goblet Cells ◽  
Middle Ear Mucosa ◽  
Whole Mount

To ascertain whether the mucous glands constitute a normal or abnormal component of the mucous membrane in the osseous Eustachian tube and middle ear, 28 prematures and newborn infants were studied. The entire mucous membrane from the Eustachian tube and middle ear was removed and stained by the PAS-alcian blue whole mount method. No mucous glands were found in the osseous tube or middle ear, although the conditions for their formation were present, there being goblet cells and stratified columnar epithelium in the osseous tube and anterior part of the middle ear. Thus, the mucous glands do not form a normal component of the middle ear mucosa, although they may be demonstrated in ears which are clinically quite normal. Minor and short lasting catarrhal affections of the tubal and middle ear mucosa — Which occur in everyone during childhood or later without leaving any other sequelae in the middle ear — may lead to the formation of a few glands. As long as only a few glands are present, the production of mucus is negligible and does not entail clinical symptoms. In chronic middle ear diseases the density of glands is relatively high, and the mucus or mucus-admixed discharge occurring in these diseases is an active product of the mucous glands and goblet cells.

scholarly journals Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

2014 ◽  
Vol 2 (1) ◽  
pp. 9-14
Author(s):  
Sheikh Shawkat Kamal
Keyword(s):  
Middle Ear ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Retrospective Case ◽  
Middle Ear Mucosa ◽  
Case Series Study ◽  
Temporal Bones ◽  
Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27  ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

Optical coherence tomography of the oval window niche

2009 ◽  
Vol 123 (6) ◽  
pp. 603-608 ◽  
Author(s):  
T Just ◽  
E Lankenau ◽  
G Hüttmann ◽  
H W Pau
Keyword(s):  
Optical Coherence Tomography ◽  
Middle Ear ◽  
Imaging Modality ◽  
Oval Window ◽  
Annular Ligament ◽  
Middle Ear Surgery ◽  
Optical Coherence ◽  
Ear Surgery ◽  
Temporal Bones

AbstractObjective:Optical coherence tomography was used to study the stapes footplate, both in cadaveric temporal bones and during middle-ear surgery.Materials and methods:Optical coherence tomography was conducted on five temporal bone preparations (from two children and three adults) and in eight patients during middle-ear surgery. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used for standard middle-ear surgical procedures.Results:This optical coherence tomography investigation enabled in vivo visualisation and documentation of the annular ligament, the different layers of the footplate and the inner-ear structures, both in non-fixed and fixed stapes footplates. In cases of otosclerosis and tympanosclerosis, an inhomogeneous and irregularly thickened footplate was found, in contrast to the appearance of non-fixed footplates. In both fixed and non-fixed footplates, there was a lack of visualisation of the border between the footplate and the otic capsule.Conclusions:Investigation of the relatively new technology of optical coherence tomography indicated that this imaging modality may assist the ear surgeon to assess the oval window niche intra-operatively.

Narrowest (ISTHMUS) Portion of Eustachian Tube: A Computer-Aided Three-Dimensional Reconstruction and Measurement Study

1997 ◽  
Vol 106 (7) ◽  
pp. 583-588 ◽  
Author(s):  
Masaharu Sudo ◽  
Isamu Sando ◽  
Akihiro Ikui ◽  
Chiaki Suzuki
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Three Dimensional ◽  
Three Dimensional Reconstruction ◽  
Cross Sectional ◽  
Computer Aided ◽  
Dimensional Reconstruction ◽  
Tensor Veli Palatini Muscle ◽  
Normal Human ◽  
Temporal Bones

Nine normal human temporal bones from persons 16 to 88 years old were studied by computer aided three-dimensional reconstruction and measurement. The length of the eustachian tube (ET) lumen in three portions (from pharyngeal orifice to tympanic orifice: cartilaginous, junctional, and bony) averaged 23.6 ±4.3 mm, 3.0 ± 1.9 mm, and 6.4 ± 2.6 mm. The narrowest portion of the ET lumen was in the cartilaginous portion in all cases: 20.5 ± 4.2 mm from the pharyngeal orifice and 3.1 ± 1.6 mm from the pharyngeal margin of the junctional portion. The cross-sectional area of the narrowest portion was 0.65 ± 0.2 mm2. The tendon of the tensor veli palatini muscle (TVPM) inserted into the lateral lamina in the narrowest portion of the ET lumen in five of nine cases. These results suggest that contraction of the TVPM opens the narrowest portion of the ET lumen to ventilate the middle ear and that this portion also plays a role in protecting the middle ear.

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 Measuring Thickness of Middle Ear Mucosa Using MRI and CT Imaging versus Histopathology

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Mary Ann Nyc ◽  
Sang Gyoon Kim ◽  
Anil Kapoor ◽  
Timothy Jung
Keyword(s):  
Middle Ear ◽  
Ct Scanning ◽  
Vehicle Control ◽  
Ct Imaging ◽  
Control Group ◽  
Middle Ear Mucosa ◽  
Treatment Groups ◽  
Mri Scans ◽  
Mucosal Thickness ◽  
Temporal Bones

Objective. Otitis media (OM) is characterized by increased middle ear effusion and inflammation of middle ear tissue. In this study, we compared two radiographic methods of analyzing inflammation by measuring mucosal thickness (MT).Methods. 28 chinchillas were divided into three treatment groups consisting of a vehicle control group and two glucocorticoid groups. 6 underwent treatment by vehicle control, 10 were treated with ciprofloxacin 0.3%/dexamethasone 0.1% (DEX), and 10 received ciprofloxacin 0.2%/hydrocortisone 1% (HC). 96 hrs post-LPS inoculation, chinchillas were euthanized and their temporal bones were removed for analyses.Results. MRI scans (F=146.0861,P-value <0.0001) and histology (χ2=40.5267,P-value <0.0001) revealed statistically significant differences in MT measurements among treatment groups, whereas CT imaging did not. DEX-treated chinchillas exhibited overall significantly smaller MT values.Conclusion. Imaging MT was effective for determining severity of inflammation due to OM. Previous gold standard methods using histopathology compromise tissue integrity by chemical manipulation and dehydration effects. MRI and CT scanning are viable tools to preserve tissue and examine changes in MT. In this study, MRI provided more information about internal, soft tissue structures. In a clinical setting, MRI could be used for diagnosing and tracking severe or chronic OM.

Functional Morphology of the Mucosa of the Middle Ear and Eustachian Tube

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 36-43 ◽  
Author(s):  
David J. Lim
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Surface Active Agent ◽  
Active Agent ◽  
Biological Significance ◽  
Normal Function ◽  
Middle Ear Mucosa ◽  
Defense Systems ◽  
Large Numbers ◽  
Surface Active

A review of available histological, histochemical and ultrastructural data on middle ear mucosa and the Eustachian tube was made to provide a broad cellular basis for understanding middle ear effusions. The presence of mucociliary defense system in a large part of the Eustachian tube and middle ear is seen as the first line of defense. Secretion by the mucosa has a profound biological significance. Immunoglobulins A, G, and even E and M are produced locally by the mucosa and may contribute to the immunodefense of the middle ear. Secretory lysozyme is also produced by the mucosa and may contribute enzymatic defense of the ear. Mucosal immunoglobulins and lysozyme are significantly elevated in the effusions, which would imply that local defense systems are hyperactive in OME. It also appears that these increases are related to the increase of the secretory cell population. It is also suspected that auditory surface-active agent is produced locally and may facilitate normal function of the tube. The middle ear also can transport macromolecules very rapidly across intact mucosal epithelium. The large numbers of tissue and wandering macrophages found in the mucosa and effusions would also imply that the middle ear is capable of efficient phagocytosis, which may be involved in processing antigen.

Eustachian Tube Lumen: Comparison between Normal and Inflamed Specimens

1989 ◽  
Vol 98 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Jacob Sadé ◽  
Michal Luntz
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Sectional Area ◽  
Secretory Otitis Media ◽  
Cross Sectional ◽  
Tube Lumen ◽  
Luminal Area ◽  
The Mean ◽  
Temporal Bones

This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube.

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