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The Pathogenesis of Chronic Secretory Otitis Media

The Pathogenesis of Chronic Secretory Otitis Media Abstract In a patient with mild chronic secretory otitis media, 488 abnormal mucous glands were found in the mucous membrane of the osseous eustachian tube and middle ear. Of these glands, 188 were active, 102 were transitional, and 198 were degenerated. The glands are described and their secretory capacity calculated. On the basis of these studies a new pathogenesis of chronic secretory otitis is presented and discussed. Owing to the influence of etiological factors, transformation of the epithelium with gland formation occurs. When the glands have completed their development they start forming mucus, which slowly accumulates in the middle ear. When the majority of the glands have started degenerating, the mucus production decreases and the disease improves spontaneously, provided that adhesive otitis has not arisen. The therapeutic program consists of (1) prevention of gland formation (2) intubation and (3) long-term follow-up of the patients. References 1. Politzer A: Lehrbuch der Ohrenheilkunde . Stuttgart, West Germany, Ferdinand Enke, 1878, p 298. 2. Bak-Pedersen K, Tos M: The mucous glands in chronic secretory otitis media . Acta Otolaryng , 72:14-27, 1971.Crossref 3. Friedmann I: The pathology of secretory otitis media . Proc Roy Soc Med 56:695-699, 1963. 4. Bendek GA: Histopathology of transudatory-secretory otitis media . Arch Otolaryng 78:33-38, 1963.Crossref 5. Sade J: Pathology and pathogenesis of serous otitis media . Arch Otolaryng 84:297-305, 1966.Crossref 6. Paparella MM, Lim DJ: Pathogenesis and pathology of the "idiopathic" blue ear drum . Arch Otolaryng 85:249-258, 1967.Crossref 7. Tos M: Mucous glands of the trachea in children. Quantitative studies . Anat Anz 126:146-160, 1970. 8. Tos M: Mucous glands of the trachea in man: Quantitative studies . Anat Anz 128:136-149, 1971. 9. Tos M: Distribution of mucous glands in the foetal eustachian-tube . Arch Klin Exp Ohr Nas Kehlkopfheilk 197:295-306, 1971.Crossref 10. Buch NH, Jorgensen MB: Eustachian tube and middle ear . Arch Otolaryng 79:472-480, 1964.Crossref 11. Polvogt L, Babb C: Histologie studies of the eustachian tube of individuals with good hearing . Laryngoscope 7:671-675, 1940. 12. Sade J, Weinberg J: Mucus production in the chronically infected middle ear . Ann Otol 78:148-155, 1969. 13. Friedmann I: The comparative pathology of otitis media—experimental and human . J Laryng 69:27-50, 1955.Crossref 14. Senturia BH, Carr CD, Ahlvin RC: Middle ear effusions: Pathologic changes of the mucoperiosteum in the experimental animal . Ann Otol 71:632-647, 1962. 15. Everberg G, Pulsen J, Rasmussen F: Den seorse otitis' klinik og behandling . Uges Laeg 130:1968-1973, 1968. 16. Tos M: Development of the tracheal glands in man . Acta Path Microbiol Scand , (suppl 185) , pp 1-130, 1966. 17. Patzelt V: Über die menschliche Epiglottis und die Entwicklung des Epithels in den Nachbargebieten . Z Anat Entwicklungsgesch 70:1-178, 1923.Crossref 18. Tos M: Development of the mucous glands in the human main bronchus . Anat Anz 123:376-389, 1968. 19. Tos M: Development of mucous glands in the human eustachian tube . Acta Otolaryng 70:340-350, 1970.Crossref 20. Sade J: Middle ear mucosa . Arch Otolaryng 84:137-143, 1966.Crossref 21. Ellefsen P, Tos M: Goblet cells in human trachea. Quantitative studies of a normal material. Anat Anz, to be published. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

The Pathogenesis of Chronic Secretory Otitis Media

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1972.00770080801004
Publisher site
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Abstract

Abstract In a patient with mild chronic secretory otitis media, 488 abnormal mucous glands were found in the mucous membrane of the osseous eustachian tube and middle ear. Of these glands, 188 were active, 102 were transitional, and 198 were degenerated. The glands are described and their secretory capacity calculated. On the basis of these studies a new pathogenesis of chronic secretory otitis is presented and discussed. Owing to the influence of etiological factors, transformation of the epithelium with gland formation occurs. When the glands have completed their development they start forming mucus, which slowly accumulates in the middle ear. When the majority of the glands have started degenerating, the mucus production decreases and the disease improves spontaneously, provided that adhesive otitis has not arisen. The therapeutic program consists of (1) prevention of gland formation (2) intubation and (3) long-term follow-up of the patients. References 1. Politzer A: Lehrbuch der Ohrenheilkunde . Stuttgart, West Germany, Ferdinand Enke, 1878, p 298. 2. Bak-Pedersen K, Tos M: The mucous glands in chronic secretory otitis media . Acta Otolaryng , 72:14-27, 1971.Crossref 3. Friedmann I: The pathology of secretory otitis media . Proc Roy Soc Med 56:695-699, 1963. 4. Bendek GA: Histopathology of transudatory-secretory otitis media . Arch Otolaryng 78:33-38, 1963.Crossref 5. Sade J: Pathology and pathogenesis of serous otitis media . Arch Otolaryng 84:297-305, 1966.Crossref 6. Paparella MM, Lim DJ: Pathogenesis and pathology of the "idiopathic" blue ear drum . Arch Otolaryng 85:249-258, 1967.Crossref 7. Tos M: Mucous glands of the trachea in children. Quantitative studies . Anat Anz 126:146-160, 1970. 8. Tos M: Mucous glands of the trachea in man: Quantitative studies . Anat Anz 128:136-149, 1971. 9. Tos M: Distribution of mucous glands in the foetal eustachian-tube . Arch Klin Exp Ohr Nas Kehlkopfheilk 197:295-306, 1971.Crossref 10. Buch NH, Jorgensen MB: Eustachian tube and middle ear . Arch Otolaryng 79:472-480, 1964.Crossref 11. Polvogt L, Babb C: Histologie studies of the eustachian tube of individuals with good hearing . Laryngoscope 7:671-675, 1940. 12. Sade J, Weinberg J: Mucus production in the chronically infected middle ear . Ann Otol 78:148-155, 1969. 13. Friedmann I: The comparative pathology of otitis media—experimental and human . J Laryng 69:27-50, 1955.Crossref 14. Senturia BH, Carr CD, Ahlvin RC: Middle ear effusions: Pathologic changes of the mucoperiosteum in the experimental animal . Ann Otol 71:632-647, 1962. 15. Everberg G, Pulsen J, Rasmussen F: Den seorse otitis' klinik og behandling . Uges Laeg 130:1968-1973, 1968. 16. Tos M: Development of the tracheal glands in man . Acta Path Microbiol Scand , (suppl 185) , pp 1-130, 1966. 17. Patzelt V: Über die menschliche Epiglottis und die Entwicklung des Epithels in den Nachbargebieten . Z Anat Entwicklungsgesch 70:1-178, 1923.Crossref 18. Tos M: Development of the mucous glands in the human main bronchus . Anat Anz 123:376-389, 1968. 19. Tos M: Development of mucous glands in the human eustachian tube . Acta Otolaryng 70:340-350, 1970.Crossref 20. Sade J: Middle ear mucosa . Arch Otolaryng 84:137-143, 1966.Crossref 21. Ellefsen P, Tos M: Goblet cells in human trachea. Quantitative studies of a normal material. Anat Anz, to be published.

Journal

Archives of Otolaryngology – American Medical Association

Published: Jun 1, 1972

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