Eustachian Tube Lymphatics

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Abstract
Serous otitis media is the most common cause of hearing impairment. The role of lymphatic obstruction in the pathogenesis of serous otitis media is significant. A method for removal of the human Eustachian tube specimen and two techniques for identification of Eustachian tube lymphatic capillaries are described. One involves the antemortem intratympanic installation of Berlin blue. The other utilizes electron microscopy. Lymphatic capillaries cannot be reliably differentiated from blood capillaries with the light microscope. With electron microscopy, lymphatic capillaries can be differentiated from blood capillaries by differences in the basement membrane. The lymphatic capillary has gaps in the basement membrane with large nuclei in the wall. A blood capillary has a continuous basement membrane and sometimes red blood cells can be identified in the lumen. Using these methods, Eustachian tube lymphatic capillaries in the human are described for the first time in this report.

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