Upper Airway Disorders

Abstract

Purpose of Study This study was conducted to define the role of inflammatory mediators in chronic middle ear disease. Methods One hundred and two patients, aged 1 to 23 years (mean age 4.9 years), with persistent otitis media with effusion unresponsive to antimicrobial therapy, were studied. Fluid was obtained during insertion of tympanotomy tubes and cultured and assayed for histamine, neutrophil chemotactic factor of anaphylaxis, and/or 13,14-dihydro-15-keto-prostaglandin F2α (a prostaglandin metabolite). Twenty-two patients also had their plasma evaluated. Findings All the mediators were higher in the middle ear effusions than in the plasma. The mean histamine content of the mucoid secretions was significantly higher than that of purulent and serous effusions. Twenty-two percent of the effusions yielded pathogenic organisms. The highest histamine levels were found in the effusions positive for Haemophilus influenzae. Conclusion These data suggest a role for the local mast cell-derived mediators in inducing or sustaining the inflammatory process involved in otitis media with effusion. Further research is needed to investigate the actual source of these mediators, their significance in otitis media with effusion and the role of the mast cell. GARY RACHELEFSKY, MD Los Angeles, CA SECRETORY igA AND BACTERIAL ADHERENCE TO NASAL MUCISAL CELLS Kurono Y, Fujiyoshi T, Mogi G.Ann Otol Rhinol Laryngol. 1989;98:273-277 Purpose of Study and Methods In works by other authors, specific bacterial adherence to mucosal cellular walls correlated well with clinical disease. With Streptococcus pyogenes the M-protein of its cellular wall is essential for adherence. Study Population Nasal mucosal cells were collected from 25 normal controls and 29 patients with chronic sinusitis.