Production of Mucus in the Middle Ear and Eustachian Tube

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Abstract
On the basis of quantitative studies of the mucus elements in 144 temporal bones and more than 5,000 biopsies the mucus producing capacity of the mucosa in the middle ear and Eustachian tube under normal conditions as well as in acute and chronic middle ear diseases is reviewed. In completely normal middle ears there was a very low goblet cell density and no mucous glands. Production of mucus does take place, but it is very slight. In acute conditions the goblet cell density in the Eustachian tube and middle ear increases, and metaplastic changes of the mucosa may occur, with formation of subepithelial and intraepithelial mucous glands. In chronic diseases, such as secretory otitis, there is a high gland and goblet cell density, which explains the increased production of mucus. In adhesive otitis the gland density is great, it is true, but most glands have become inactive and have degenerated. In chronic suppurative otitis, cholesteatoma, and sequelae to chronic otitis the goblet cell and gland density is moderately increased, but there are very marked individual variations which explain the great difference in the production of mucus. In active chronic diseases the mucus elements may increase enormously, and the mucus producing capacity of the epithelium may reach the heights of that of the respiratory mucosa.