Prostaglandins and Otitis Media: Studies in the Chinchilla

Prostaglandins (PG) are naturally occurring, cyclic, unsaturated fatty acids that possess a wide range of potent biologic activities. Prostaglandins have been found in human middle ear effusions and may have implications for understanding the inflammation and, possibly, the bone resorption seen in chronic otitis media. In the study presented, PGs were measured by radioimmuno-assay in middle ear effusions from experimentally induced serous and purulent otitis media in chinchillas. The ability of chinchilla middle ear mucosa to synthesize PGs from 14C-arachidonic acid was also demonstrated. The authors suggest an active role for PGs in the inflammation and the bone resorption seen in otitis media.

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Effect of Prostaglandin on the Composition of Chinchilla Middle Ear Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800890s338 ◽

1980 ◽

Vol 89 (3_suppl) ◽

pp. 153-160 ◽

Cited By ~ 4

Author(s):

Timothy T. K. Jung ◽

S. K. Juhn ◽

Douglas M. Smith ◽

Jonathan M. Gerrard

Keyword(s):

Alkaline Phosphatase ◽

Bone Resorption ◽

Otitis Media ◽

Middle Ear ◽

Time Course ◽

Unsaturated Fatty Acids ◽

Biological Activities ◽

Middle Ear Mucosa ◽

Acid And Alkaline Phosphatase ◽

Wide Range

Prostaglandins (PGs) are naturally occurring, cyclic, unsaturated fatty acids which possess a wide range of potent biological activities. PGs have been found in human middle ear effusions and might have implications for understanding the inflammation and possibly the bone resorption seen in chronic otitis media. We have measured PGs by radioimmunoassay in middle ear effusions (MEE) from experimentally induced serous otitis media (SOM) and purulent otitis media (POM) in chinchillas. PGE2 levels were significantly higher in the POM group compared to the SOM group. We have also demonstrated that chinchilla middle ear mucosa can convert arachidonic acid (AA), a precursor of PGs, to PG by injecting 14C-AA into bullae and assaying using radiochromatography. This conversion was completely blocked by both indomethacin and aspirin given orally or by direct injection into the middle ear. We then injected 50 μg of PGE2 into chinchilla bullae to assess its effect on the composition of MEE. First, the time course of PGE2 metabolism after its injection into the middle ear (ME) was determined by thin-layer chromatography (TLC) of labelled and unlabelled PGE2. Following this, serial daily injections of PGE2 and normal saline as control were made for one, three, and seven days. MEE and serum were collected and assayed for lactate dehydrogenase (LDH), acid and alkaline phosphatase, calcium, protein and hexosamine. Compared to the control, the levels of LDH, acid and alkaline phosphatase, calcium and protein were significantly elevated. Hexosamine levels were higher than the control at one and three days but did not differ significantly at seven days from the control. We have therefore demonstrated that chinchilla middle ear mucosa has the ability to synthesize PG from AA and suggest an active role for PGs in the inflammation and in the bone resorption seen in otitis media.

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Characterization of mucins in human middle ear and Eustachian tube

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.2001.280.6.l1157 ◽

2001 ◽

Vol 280 (6) ◽

pp. L1157-L1167 ◽

Cited By ~ 58

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.

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Pre-operative predictors of ossicular necrosis in chronic otitis media-mucosal type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190769 ◽

2019 ◽

Vol 5 (2) ◽

pp. 396

Author(s):

Razim Abdul Rasheed ◽

Mubeena . ◽

K. S. Gangadhara Somayaji

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Granulation Tissue ◽

Chronic Otitis Media ◽

Ossicular Chain ◽

Bivariate Analysis ◽

Middle Ear Mucosa ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Wide Range

Background: Chronic suppurative otitis media can cause a wide range of pathologies in the middle ear that include irreversible mucosal changes, granulation tissue formation, cholesteatoma, tympanosclerosis, and destruction of ossicles. Knowledge regarding ossicular discontinuity before surgery enables the surgeon to be prepared for ossiculoplasty. Objective was to study the pre-operative clinical, audiological and microscopic findings in chronic otitis media mucosal type and correlate preoperative findings with intra-operative ossicular necrosis. Methods: Study design was observational, descriptive and cross sectional study. All patients were subjected to detailed clinical, otoscopic and microscopic examination to assess the size and site of perforation, presence or absence of ear discharge, granulation tissue, tympanosclerosis in the middle ear, exposure of incudostapedeal joint and condition of middle ear mucosa. Pure tone audiogram was also done. All patients underwent tympanoplasty±cortical mastoidectomy and the intraoperative findings of ossicular necrosis were noted. Results: Of the 105 patients, 18(17.1%) had ossicular necrosis. Bivariate analysis showed positive correlation for long standing disease (p=0.004), presence of discharging ear (p=0.014), polypoidal middle ear mucosa (p=0.000) granulations in middle ear (p=0.000) and also when incudostapedeal joint was exposed (p=0.005). Mean Air bone gap was higher with 35 dB in ossicular necrosis and 22.7 dB in intact ossicular chain was also statistically significant (p=0.0001).Conclusions: Ossicular necrosis was best indicated by the presence of polypoidal mucosa, granulation in the middle ear and higher air-bone gap on audiometry. However longer duration of disease, persistent active stage of disease and exposure of incudostapedeal joint were also found to be significant.

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S224 – Efficacy of Long Silastic Sheet in COM Surgery

Otolaryngology ◽

10.1016/j.otohns.2008.05.399 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P150-P150

Author(s):

Hyong-Ho Cho ◽

Hyun-Seok Choi ◽

Chul-Ho Jang ◽

Yong-Bum Cho

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Valsalva Maneuver ◽

Chronic Otitis Media ◽

Mastoid Cavity ◽

Middle Ear Mucosa ◽

Hearing Result ◽

Staged Operation ◽

Canal Wall Up

Objectives To determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery. Methods Between January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared. Results During the average follow-up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air-Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05). Conclusions Long silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first-stage operation.

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Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media

JAMA ◽

10.1001/jama.296.2.202 ◽

2006 ◽

Vol 296 (2) ◽

pp. 202 ◽

Cited By ~ 588

Author(s):

Luanne Hall-Stoodley ◽

Fen Ze Hu ◽

Armin Gieseke ◽

Laura Nistico ◽

Duc Nguyen ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Direct Detection ◽

Chronic Otitis Media ◽

Bacterial Biofilms ◽

Middle Ear Mucosa

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High Human Papillomavirus DNA loads in Inflammatory Middle Ear Diseases

Pathogens ◽

10.3390/pathogens9030224 ◽

2020 ◽

Vol 9 (3) ◽

pp. 224 ◽

Cited By ~ 4

Author(s):

Nicola Malagutti ◽

John Charles Rotondo ◽

Luca Cerritelli ◽

Claudio Melchiorri ◽

Monica De Mattei ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Dna Sequences ◽

Direct Sequencing ◽

Chronic Otitis Media ◽

Human Papillomaviruses ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Ear Diseases ◽

Hpv Dna

Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. We investigated 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 (NME) specimens (n = 56) were analyzed. HPV sequences and DNA loads were analyzed by quantitative-PCR. HPV genotyping was performed by direct sequencing. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) of NME (p > 0.05). Specifically, HPV DNA sequences were found in 26.3% (10/38) of CSOM and in 14.3% (2/14) of COMC (p > 0.05). 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 = 0.03 and P = 0.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. These data suggest that HPV may infect the middle ear mucosa, whereas HPV-positive COMCs are associated with higher viral DNA loads as compared to NME.

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Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

The Scientific World JOURNAL ◽

10.1155/2013/638715 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Ercan Kaya ◽

Ilknur Dag ◽

Armagan Incesulu ◽

Melek Kezban Gurbuz ◽

Mustafa Acar ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Tissue Samples ◽

Scanning Electron

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894941030s505 ◽

1994 ◽

Vol 103 (5_suppl) ◽

pp. 15-19 ◽

Cited By ~ 24

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.

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