Adaptive Bone Modeling and Remodeling in Acute Otitis Media Caused by Non-typeable or Type B Haemophilus influenzae or Moraxella catarrhalis

Abstract

Experimental studies have shown that acute otitis media caused by Streptococcus pneumoniae alters modeling dynamics in bone tissue structures surrounding the middle ear cavity. Initial resorption of bone is followed by formative activity, seen as massive osteoneogenesis. However, neither resorptive nor formative activity occurs in the otic capsule, supporting the existence of a perilymphatic zone of specialized bone. This study investigates adaptive bone modeling in acute otitis media caused by other bacteria frequently encountered in this disease. Seventy-five rats were inoculated with either non-typeable or type b Haemophilus influenzae, or Moraxella catarrhalis (25 rats in each group). Five rats from each group were sacrificed on days 4, 8, 16, 60 and 180 post-inoculation. Qualitative as well as quantitative histopathology revealed increasing apposition of new bone on both sides of the original bony wall of the middle ear bulla, i.e. at the inner and outer periosteum. Remodeling activity was seen on later days of sacrifice, as typical osteone (Haversian system) formation. Measured bone thickness in four anatomically well-defined localities progressed to a peak 2 months post-inoculation, followed by some degree of normalization. However, bone thickness was still massively increased 6 months after the acute incident. Except in the otic capsule, resorptive and formative activity was found in all bone tissue structures surrounding the middle ear cavity. These findings were irrespective of the type of inoculated bacteria. However, non-typeable or type b Haemophilus influenzae induces significantly more new bone formation than Moraxella catarrhalis. We conclude that acute otitis media caused by either of the bacteria is accompanied by massive and progressive net osteoneogenesis, already evident on day 4 and peaking 2 months post-inoculation, followed by some degree of normalization. Non-typeable and type b Haemophilus influenzae induce more new bone formation than Moraxella catarrhalis, whereas other features of bone histomorphology were equivalent. The present findings further support the existence of a perilymphatic zone of specialized bone.