Functional Disorder of Eustachian Tube in Experimental Otitis Media with Effusion following Inoculation of Bacterial Endotoxin

1988 ◽  
Vol 97 (4) ◽  
pp. 422-426 ◽  
Author(s):  
Yoshiaki Nakai ◽  
Yusuke Esaki ◽  
Yoshihiro Ohashi ◽  
Hiroshi Ikeoka ◽  
Shoko Kato ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Ciliary Activity ◽  
Functional Disorder ◽  
Epithelial Morphology ◽  
Mucociliary System ◽  
Morphologic Changes

A 10-μg/mL solution of lipopolysaccharide derived from Klebsiella pneumoniae was inoculated into the middle ears of guinea pigs. The animals were killed painlessly on the first, third, or seventh day after inoculation, and the mucosal samples from the bony portion of the eustachian tube were examined for ciliary activity and epithelial morphology. On the first and third days, when middle ear effusions were present, deterioration of ciliary activity and morphologic changes in the mucociliary system were observed. On the seventh day, when middle ear effusions were absent, the ciliary activity had recovered to normal. Our data show that endotoxin extracted from K pneumoniae can produce otitis media with effusion and that dysfunction of cilia caused by endotoxin is a factor responsible for the manifestation of otitis media.

Mucociliary Disease of the Middle Ear during Experimental Otitis Media with Effusion Induced by Bacterial Endotoxin

1989 ◽  
Vol 98 (6) ◽  
pp. 479-484 ◽  
Author(s):  
Yoshiaki Nakai ◽  
Hiroshi Ikeoka ◽  
Yoshihiro Ohashi ◽  
Hiroyuki Furuya ◽  
Shoko Kato ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Laboratory Animals ◽  
Ciliary Activity ◽  
Defense System ◽  
Middle Ear Effusion ◽  
Epithelial Morphology ◽  
Mucociliary System ◽  
Ear Effusion

Lipopolysaccharide (10 μg/mL) derived from Klebsiella pneumoniae was injected into the middle ear of guinea pigs. The animals were killed painlessly on days 1, 3, and 7 after inoculation, and the mucosal samples from two sites within the tympanic cavity, close to the tympanic orifice and distal to the orifice, were examined for ciliary activity and epithelial morphology. At day 1 and day 3 serous effusion was observed and deterioration of ciliary activity and morphologic changes were observed. No effusion was recognized at day 7, when the ciliary activity in the distal mucosa was still diminished and that in the proximal mucosa had recovered to a normal level. Our data have shown that lipopolysaccharide extracted from K pneumoniae can produce otitis media with effusion in laboratory animals, and dysfunction of cilia due to lipopolysaccharide probably is responsible for the accumulation of middle ear effusion. The mucociliary system is indeed an important defense system and failure of such a system, especially in the mucosa close to the tympanic orifice, can cause the buildup of effusions.

Effects of Platelet Activating Factor on the Tubotympanic Mucosa and Inner Ear in the Guinea Pig

1998 ◽  
Vol 107 (10) ◽  
pp. 876-884 ◽  
Author(s):  
Yoshiharu Ohno ◽  
Yoshihiro Ohashi ◽  
Hideki Okamoto ◽  
Yoshikazu Sugiura ◽  
Yoshiaki Nakai
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Platelet Activating Factor ◽  
Sensorineural Hearing ◽  
Ciliary Activity ◽  
Middle Ear Mucosa

The effect of platelet activating factor (PAF) was studied to elucidate its role in the pathogenesis of otitis media and sensorineural hearing loss. The PAF alone did not induce a reduction of ciliary activity of the cultured middle ear mucosa. However, a dose-dependent decrease in ciliary activity was observed in the presence of the medium containing both PAF and macrophages. Intravenous injection of PAF did not induce dysfunction of the mucociliary system or morphologic changes of epithelium in the tubotympanum, but cytoplasmic vacuolization and ballooning were observed in the inner ear within 1 hour after injection of PAF. In contrast, intratympanic injection of PAF induced mucociliary dysfunction and some pathologic changes in the tubotympanum. Intratympanic inoculation of PAF induced no pathologic findings in the inner ear. These results suggest that PAF is at least partially involved in the pathogenesis of certain middle ear diseases such as otitis media with effusion. Additionally, PAF might be involved in the pathogenesis of some types of unexplained sensorineural hearing loss.

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.

Pseudomonas Otitis Media after Eustachian Tube Obstruction

1992 ◽  
Vol 107 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Patrick J. Antonelli ◽  
Steven K. Juhn ◽  
Marcos V. Goycoolea ◽  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Tube Obstruction ◽  
Colony Forming Units ◽  
Tube Function ◽  
Pseudomonas Infection

Previous experiments have shown that Pseudomonas aeruginosa may infect the middle ears of chinchillas by way of the eustachian tube and that chinchillas with acute otitis media (AOM) are more susceptible to pseudomonas infection than animals without AOM. The purpose of this experiment was to examine the effects of otitis media with effusion (OME), induced by means of eustachian tube obstruction, on middle ear susceptibility to nasal inoculation of P. aeruginosa. Chinchilla eustachian tubes were obstructed with silicone rubber sponge bilaterally; OME developed in eight animals (11 ears)—three bilaterally and five unilaterally—and persisted for 6 months. Ten chinchillas with normal eustachian tube function served as controls. All animals were nasally inoculated with 5 times 104 colony-forming units of P. aeruginosa. Pseudomonas otitis media developed in eight of 11 OME ears with effusion, none of five ears without OME, and four of 20 control ears (X2 = 11.782, p = 0.003). Therefore, P. aeruginosa can infect the middle ear by way of the eustachian tube. Tubal dysfunction may lead to the development of chronic suppurative otitis media by increasing tubotympanic susceptibility to opportunistic pathogens.

scholarly journals Tympanometric changes following adenoidectomy in children with adenoid hypertrophy

2018 ◽  
Vol 4 (2) ◽  
pp. 391 ◽  
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Maximum Size ◽  
Adenoid Hypertrophy ◽  
Tube Obstruction ◽  
Media Type ◽  
Middle Ear Pressure ◽  
Pressure Changes

<p class="abstract"><strong>Background:</strong> Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect  of  adenoidectomy on Otitis Media with Effusion.</p><p class="abstract"><strong>Methods:</strong> Patients showing &gt;50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied.  </p><p class="abstract"><strong>Results:</strong> Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.</p>

Eustachian Tube Function and Allergy in Otitis Media

PEDIATRICS ◽  
1978 ◽  
Vol 61 (5) ◽  
pp. 753-760
Author(s):  
Charles D. Bluestone
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Disease Process ◽  
Exact Nature ◽  
Protective Function ◽  
Radiographic Technique ◽  
Tube Function ◽  
Glue Ear

Otitis media with effusion (OME) is one of the most common diseases of childhood. Acute OME is usually of the suppurative type, although it may be serous, while chronic OME has many synonyms, including "serous otitis media," "mucoid otitis," "nonsuppurative otitis media," "glue ear," and "allergic otitis media." The following discussion is a review of some of the factors that influence the etiology and pathogenesis of OME in general, and more specifically the role of Eustachian tube (ET) function and allergy in the disease process of OME. The pathogenesis of OME appears to be related to abnormal function of the ET. Investigation into the exact nature of this dysfunction requires an understanding of the system constituted by the palate, nasal cavity, nasopharynx, ET, middle ear, and mastoid air cells. Within this system the ET has at least three physiologic functions with respect to the middle ear: protection from nasopharyngeal sound pressure and secretions, clearance into the nasopharynx of secretions produced within the middle ear, and ventilation of the middle ear to equilibrate air pressure in the middle ear with atmospheric pressure and to replenish oxygen which has been absorbed (Fig. 1). ROENTGENOGRAPHIC STUDIES The protective and clearance functions of the ET have been assessed by a radiographic technique.1,2 Radiopaque material was instilled through the nose of patients in order to observe the retrograde flow of the medium from the nasopharynx into the ET. Patients were considered to have normal protective function when radiopaque material entered only the nasopharyngeal or isthmic portion of the tube but did not enter the bony portion of the tube or middle ear cavity.

Biological Mediators of Inflammation in Middle Ear Effusions

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 90-96 ◽  
Author(s):  
Joel M. Bernstein
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Potential Role ◽  
Otitis Media With Effusion ◽  
Chemotactic Factor ◽  
Mediators Of Inflammation ◽  
Tube Dysfunction ◽  
Middle Ear Cleft

Four biological mediators of inflammation have been found in middle ear effusions from patients with otitis media with effusion. They are chemotactic factor(s), macrophage inhibition factor(s), activated complement and prostaglandins. The potential role of these mediators has been discussed in relation to their potential for maintaining inflammation in the middle ear cleft after Eustachian tube dysfunction.

Experimental otitis media with effusion induced by lipopolysaccharide from Klebsiella pneumoniae: Mucociliary pathology of the middle ear

1988 ◽  
Vol 9 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Yoshihiro Ohashi ◽  
Yoshiaki Nakai ◽  
Hiroshi Ikeoka ◽  
Yusuke Esaki ◽  
Shoko Kato ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion

Relation between Nasal and Middle Ear Allergy Experimental Study

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 147-152 ◽  
Author(s):  
Toshio Yamashita ◽  
Nobuhiro Okazaki ◽  
Tadami Kumazawa
Keyword(s):  
Experimental Study ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Guinea Pigs ◽  
Otitis Media With Effusion ◽  
The Other ◽  
Nasal Allergy ◽  
Tympanic Cavity ◽  
Direct Relation

This study was undertaken to clarify the relation between nasal allergy and otitis media with effusion and to observe histologically the allergic changes in the eustachian tube itself in animals. Allergic changes in the eustachian tube and tympanic cavity were clearly observed histologically when the antigen had been introduced into the tympanic cavity of sensitized guinea pigs. On the other hand, administration of the antigen into the nose produced marked allergic changes in the nose and pharynx but no change in the eustachian tube or tympanic cavity. In view of these findings, it is suggested that allergy of the nose bears little direct relation to that of the middle ear and the eustachian tube.

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