Delayed ultrastructural radiation induced changes in the human mesotympanic middle ear mucosa

The irradiation-induced changes in the middle ear mucosa of six patients were described and discussed. The epithelium showed marked reduction of the cytoplasmic mass, variable degrees of ciliary loss and widening of the intercellular spaces with disruption of some of the maculae adherentes. The connective tissue stroma showed increased production of collagenous fibrous tissue and increased number of synthetically active fibroblasts. New gland formation has been observed and the glands exhibited reduced activity. The endothelial cells of some blood capillaries were swollen and the basal lamina was duplicated. The lumina of other capillaries were completely obliterated and replaced by a cord of fibrous tissue.     

Effect of recombinant interleukin-1 beta on microbial flora of the middle ear in patients with chronic purulent otitis media

Betaleukin was given to 60 patients with various forms of otitis media purulenta chronica (OMPC). Symptoms of the purulent exacerbation were relieved in 43.3% of the patients, the clinical course improved in 18.3%. No response was achieved in 40% of the treated patients. Betaleukin proved highly effective in management of exacerbations of uncomplicated OMPC though it has no direct antimicrobial activity.     

Severe acute middle ear infections: microbiology and treatment

OBJECTIVE: The database at the ENT-Department, Aarhus University Hospital describing the specific local flora of acute otitis media (AOM) and acute mastoiditis (AM) in Aarhus County has become the key element in securing a rational and specific antibiotic treatment. We present our data concerning AOM, mastoidismus and AM. Our purpose is to determine (I) clinical presentation, (II) causative pathogens, (III) resistance patterns, (IV) type of antibiotic treatment, and (V) accuracy of the antibiotic treatment. METHODS: Patients under the age of 18 years, treated for AOM with extensive affected well-being and AM, at the ENT-Department, Aarhus University Hospital during 3 years from January 2001 to December 2003. RESULTS: A total of 106 patients were identified. Sixty-seven patients with AOM and 39 patients with AM. The overall bacterial flora found is dominated by S. pneumococci all 100% susceptible to penicillin. However, Staphylococcus aureus is the primary bacterial pathogens cultured from patients treated with preadmission antibiotics. CONCLUSION: If a specimen from an AOM patient is obtained after the initiation of antibiotic treatment one should consider the possibility of the culture found being a result of the initial led treatment and not the causative AOM pathogen. Our data suggest that a restricted use of antibiotics in children with AOM may be associated with a higher incidence of acute mastoiditis. Significant higher leucocytes count and CRP are found in the acute mastoiditis group compared to the AOM group.     

Histochemistry of normal middle ear mucosa.

Mucosal biopsy specimens were taken from the middle ear in 19 patients with otosclerosis and stained by Alcan blue and PAS. They were also stained for hydrolytic and oxidative enzymes. In additon, 11 temporal bones from patients without any previous ear disease were serially sectioned for mucopolysaccharides. In otosclerosis, both acid and neutral mucopolysaccharides were present in the mucosa, but not to the same extent as in the temporal bone specimens. Acid phosphatase, lactate malate dehydrogenases, and nonspecific esterase were demonstrated even in very thin epithelium, providing a potential basis for the appearance of these enzymes in large amounts in various inflammatory middle ear diseases.     

Mast cells in chronic inflammation of the middle ear mucosa

AIM OF THE STUDY: The number, distribution and degranulation frequency of mast cells have been studied in the middle ear mucosa biopsies of patients with chronic otitis media. MATERIALS AND METHODS: The pathohistological analysis has been performed on 115 biopsy specimens, taken intraoperatively from the different regions of the middle ear cleft in 27 patients with chronic otitis media and in 15 children with otomastoiditis which occurred during the treatment of secretory otitis media. Mast cells were identified on the basis of metachromatic staining for histamine and heparin granules. RESULTS: The findings of this study confirm that the number of mast cells is increased in all areas of middle ear cleft in chronic inflammation of the middle ear mucosa. Mast cells were identified in 108 out of 115 analysed samples. In chronic otitis media of atticoantral and tubotympanic type mast cells were present in 91.5% of samples, the cells with heparin granules were present in 62.2% and degranulation frequency was 37.8%. In secretory otitis media 33 mucosal samples were analysed and all samples contained mast cells with predominance of histamine granules and with de granulation frequency of 81.8%. CONCLUSION: These findings indicate that mast cells have complex function in pathophysiology of chronic inflammation of the middle ear mucosa: it may take part in amplification of inflammation as well as in its limitation. Further studies are needed to clarify the role of histamine and heparin in chronic inflammatory reactions of the middle ear mucosa.     

Studies on the mechanics of the normal human middle ear

The middle ear was studied in temporal bone preparations using a laser-Doppler interferometer. For measurements at a sound level of 80 dB SPL this method proved to be very reliable, as was shown by good reproducibility of results in experiments over more than 6 hours. The vibrations of the tympanic membrane and stapes footplate were studied from 200 Hz to 10 KHz and the results demonstrate a piston-like movement of the stapes footplate up to 120 dB SPL. The damping effect of the normal ear is located mainly at the footplate/cochlea level and the middle ear cavity per se does not contribute significantly to the stiffness of the middle ear system.