Middle Ear Mucosa in Chronic Effusions (With 1 color plate)

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Abstract
Biopsies of the middle ear mucosa were performed in 11 patients receiving their first ventilation tubes and in 5 patients who were admitted for reinsertion of tubes for chronic mucoid effusion. All patients had had the disease for at least 6 months. Mucosubstances were seen in the form of a mucus blanket, and as positive staining in the apical parts of the epithelial cells. Goblet cells varied greatly in frequency and larger subepithelial glands were present in cases of longer duration and intermittent discharge. In the majority of specimens, mononuclear cells were frequent in the propria, forming lymphocyte follicles in some cases. One-third of the specimens showed distinct fibrotic changes, and only a few inflammatory cells were present. Thus, mucosal response consisted of immune cells and could be due to chronic irritation, caused by bacteria and their immune complexes. Polymorphonuclear leukocytes were not present except in the effusion itself, a circumstance which points to infection as the causative factor. Pronounced proprial changes may indicate irreversibility of the disease.

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