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Pathogenesis of Middle Ear Adhesions
- Source :
- The Laryngoscope. 106:463-469
- Publication Year :
- 1996
- Publisher :
- Wiley, 1996.
-
Abstract
- Middle ear adhesions are well-known to the ear surgeon, although data on etiology, pathogenesis, and significance are lacking in current literature. This study on experimental acute otitis media presents histopathological data on these aspects. Pneumococci were inoculated in the right middle ear bulla of 25 rats; the left ear served as control. At days 4, 8, 16, 90, and 180, respectively, 5 rats were decapitated, and the bullae were removed, opened, and stained with periodic acid-Schiff (PAS)/alcian blue. The entire middle ear mucosae were dissected from the bone, embedded as whole mounts in colophonium chambers, and examined by light microscopy. Representative parts of the mucosae were sectioned and examined in the same way. All inoculated ears from day 8 and later (20 in total), contained mucosal adhesions of various sizes, shapes, and locations. None were found in control ears. The site of predilection for the development of adhesions was the hypotympanum, followed by the anterior epitympanum, the attic, the drum, the interossicular spaces, and the tubal orifice. Based on present histopathological findings, we conclude that the middle ear adhesion is a pathological phenomenon caused by infection, and we propose a six-stage hypothesis of pathogenesis: 1. Localized epithelial rupture; 2. Prolapse of subepithelial tissue; 3. Epithelialization of the prolapse; resulting in a polypous/fold-like prominence; 4. Growth and elongation of the prominence; 5. Fusion of the end/tip of the prominence with another part of the mucosa; 6. Formation of an adhesion.
- Subjects :
- Male
Pathology
medicine.medical_specialty
Time Factors
Acute otitis media
Ear, Middle
Adhesion (medicine)
Tissue Adhesions
Otitis Media, Suppurative
Pneumococcal Infections
Rats, Sprague-Dawley
Pathogenesis
Random Allocation
otorhinolaryngologic diseases
medicine
Animals
Bulla (seal)
Pathological
Mucous Membrane
business.industry
Anatomy
Entire middle ear
medicine.disease
Rats
Disease Models, Animal
medicine.anatomical_structure
Otorhinolaryngology
Acute Disease
Middle ear
business
Complication
Subjects
Details
- ISSN :
- 15314995 and 0023852X
- Volume :
- 106
- Database :
- OpenAIRE
- Journal :
- The Laryngoscope
- Accession number :
- edsair.doi.dedup.....1079b54659f1fca52640969b68375abe