Morphological Basis for Impaired Protective Efficiency by the Nasal Mucosa in Infants with and without Recurrent Acute Otitis media: A Light and Electron Microscopy Study

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Abstract
The structure of the nasal mucosa in biopsy specimens from the inferior turbinate in ‘normal healthy’ infants (n = 27) was compared with that in age-matched infants (n = 59) with increased frequency of recurrent acute otitis media (RAOM). Light and transmission electron microscopic examination revealed that the healthy infants, i.e., the control subjects, had almost as extensive structural changes in their nasal mucosa as those with RAOM. Only 1 infant in each group was considered to have normal nasal mucosa from a morphological point of view. The high frequencies of structural abnormalities in the nasal mucosa in infants, healthy or with RAOM, is likely to be due to frequent infections causing damage so often and to such high extent that the repair processes became insufficient and thus did not restore the structure of the nasal mucosa. Mucosal lining defects may decrease the resistance to infections, resulting in frequent relapses further adding to the mucosal damage, i.e., a self-ongoing circle.