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The Outset of Chronic Secretory Otitis Media: A Histopathological Study of the Earliest Stage

The Outset of Chronic Secretory Otitis Media: A Histopathological Study of the Earliest Stage Abstract Histopathological study of the earliest stage of secretory otitis was made in a 3-month-old infant. The entire mucosa was examined by the whole-mount method, with determination of gland count and goblet-cell density, followed by assessment of serial sections. The first changes are inflammatory with lymphocytic infiltration, dilatation, and increase of blood vessels. These again induce metaplasia into pseudostratified, ciliated epithelium, increase in goblet-cell density, and formation of intraepithelial and subepithelial mucous glands. Basal cells divide and grow down into lamina propria, giving rise to a solid cylinder that gets canalized. Cells of this cylinder differentiate into ciliated and mucous cells, so that tubules acquire a lining of typical pseudostratified, ciliated, columnar epithelium. The most important processes in the early stage of secretory otitis are hyperplasia, differentiation of epithelial cells, and gland formation. When glands have completed their development, they produce mucus that accumulates in the middle ear, and the disease enters the secretory stage. References 1. Friedmann I: The pathology of secretory otitis media . Proc R Soc Med 56:695-699, 1963. 2. Paparella MM, Lim DJ: Pathogenesis and pathology of the "idiopathic" blue ear drum . Arch Otolaryngol 85:249-258, 1967.Crossref 3. Bendek GA: Histopathology of transudatory-secretory otitis media . Arch Otolaryngol 78:33-38, 1963.Crossref 4. Sade J: Pathology and pathogenesis of serous otitis media . Arch Otolaryngol 84:297-305, 1966.Crossref 5. Hentzer E: Ultrastructure of the middle-ear mucosa in secretory otitis media: II. Mucous effusion . Acta Otolaryngol 73:467-475, 1972.Crossref 6. Bak-Pedersen K, Tos M: The mucous glands in chronic secretory otitis media . Acta Otolaryngol 72:14-27, 1971.Crossref 7. Bak-Pedersen K, Tos M: Density of goblet cells in the human Eustachian tube . Acta Otolaryngol 74:197-205, 1972.Crossref 8. Bak-Pedersen K, Tos M: Density of goblet cells in chronic secretory otitis media: A temporal bone report . Rev Laryngol Otol Rhinol 94:27-34, 1973. 9. Tos M, Bak-Pedersen K: The pathogenesis of chronic secretory otitis media . Arch Otolaryngol 95:511-521, 1972.Crossref 10. Tos M, Bak-Pedersen K: Density of mucous glands in a biopsy material of chronic secretory otitis media . Acta Otolaryngol 75:55-60, 1973.Crossref 11. Tos M, Bak-Pedersen K: Density of mucous glands in chronic adhesive otitis media . Arch Oto Rhino Laryngol 206:39-46, 1973.Crossref 12. Tos M: Distribution of mucous glands in the foetal Eustachian tube . Arch Klin Exp Ohren Nasen Kehlkopfheilkd 197:295-306, 1971.Crossref 13. Buch NH, Jørgensen MB: Eustachian tube and middle ear . Arch Otolaryngol 79:472-480, 1964.Crossref 14. Bak-Pedersen K, Tos M: Middle ear mucosa in newborn infants . Ann Otol Rhinol Laryngol 83:168-173, 1974. 15. Bak-Pedersen K, Tos M: Mucous glands in the middle ear and osseous tube in children . Minerva Otol 23:202-210, 1973. 16. Tos M: Mucous glands of the trachea in children: Quantitative studies . Anat Anz 126:146-160, 1970. 17. Hentzer E: Ultrastructure of the middle ear mucosa in secretory otitis media: I. Serous secretion . Acta Otolaryngol 73:394-401, 1972.Crossref 18. Tos M, Bak-Pedersen K: Intraepithelial glands in the human Eustachian tube . Arch Otolaryngol 96:546-552, 1972.Crossref 19. Bak-Pedersen K, Tos M: Density of mucous glands in various chronic middle ear diseases . Acta Otolaryngol 75:273-274, 1973.Crossref 20. Sade J: Middle ear mucosa . Arch Otolaryngol 84:137-143, 1966.Crossref 21. Hentzer E: Ultrastructure of the normal mucosa in the human middle ear, mastoid cavities, and Eustachian tube . Ann Otol Rhinol Laryngol 79:1143-1157, 1970. 22. Lim DJ, Hussl B: Human middle ear epithelium: An ultrastructural and cytochemical study . Arch Otolaryngol 89:835-849, 1969.Crossref 23. Tos M: Development of mucous glands in the human Eustachian tube . Acta Otolaryngol 70:340-350, 1970.Crossref 24. Tos M: Development of the tracheal glands in man . Acta Pathol Microbiol Scand , (suppl 185) , 1966. 25. Vered J, Eliezer N, Sade J: Biochemical characterization of middle ear effusions . Ann Otol Rhinol Laryngol 81:394-400, 1972. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

The Outset of Chronic Secretory Otitis Media: A Histopathological Study of the Earliest Stage

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1975.00780310045013
Publisher site
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Abstract

Abstract Histopathological study of the earliest stage of secretory otitis was made in a 3-month-old infant. The entire mucosa was examined by the whole-mount method, with determination of gland count and goblet-cell density, followed by assessment of serial sections. The first changes are inflammatory with lymphocytic infiltration, dilatation, and increase of blood vessels. These again induce metaplasia into pseudostratified, ciliated epithelium, increase in goblet-cell density, and formation of intraepithelial and subepithelial mucous glands. Basal cells divide and grow down into lamina propria, giving rise to a solid cylinder that gets canalized. Cells of this cylinder differentiate into ciliated and mucous cells, so that tubules acquire a lining of typical pseudostratified, ciliated, columnar epithelium. The most important processes in the early stage of secretory otitis are hyperplasia, differentiation of epithelial cells, and gland formation. When glands have completed their development, they produce mucus that accumulates in the middle ear, and the disease enters the secretory stage. References 1. Friedmann I: The pathology of secretory otitis media . Proc R Soc Med 56:695-699, 1963. 2. Paparella MM, Lim DJ: Pathogenesis and pathology of the "idiopathic" blue ear drum . Arch Otolaryngol 85:249-258, 1967.Crossref 3. Bendek GA: Histopathology of transudatory-secretory otitis media . Arch Otolaryngol 78:33-38, 1963.Crossref 4. Sade J: Pathology and pathogenesis of serous otitis media . Arch Otolaryngol 84:297-305, 1966.Crossref 5. Hentzer E: Ultrastructure of the middle-ear mucosa in secretory otitis media: II. Mucous effusion . Acta Otolaryngol 73:467-475, 1972.Crossref 6. Bak-Pedersen K, Tos M: The mucous glands in chronic secretory otitis media . Acta Otolaryngol 72:14-27, 1971.Crossref 7. Bak-Pedersen K, Tos M: Density of goblet cells in the human Eustachian tube . Acta Otolaryngol 74:197-205, 1972.Crossref 8. Bak-Pedersen K, Tos M: Density of goblet cells in chronic secretory otitis media: A temporal bone report . Rev Laryngol Otol Rhinol 94:27-34, 1973. 9. Tos M, Bak-Pedersen K: The pathogenesis of chronic secretory otitis media . Arch Otolaryngol 95:511-521, 1972.Crossref 10. Tos M, Bak-Pedersen K: Density of mucous glands in a biopsy material of chronic secretory otitis media . Acta Otolaryngol 75:55-60, 1973.Crossref 11. Tos M, Bak-Pedersen K: Density of mucous glands in chronic adhesive otitis media . Arch Oto Rhino Laryngol 206:39-46, 1973.Crossref 12. Tos M: Distribution of mucous glands in the foetal Eustachian tube . Arch Klin Exp Ohren Nasen Kehlkopfheilkd 197:295-306, 1971.Crossref 13. Buch NH, Jørgensen MB: Eustachian tube and middle ear . Arch Otolaryngol 79:472-480, 1964.Crossref 14. Bak-Pedersen K, Tos M: Middle ear mucosa in newborn infants . Ann Otol Rhinol Laryngol 83:168-173, 1974. 15. Bak-Pedersen K, Tos M: Mucous glands in the middle ear and osseous tube in children . Minerva Otol 23:202-210, 1973. 16. Tos M: Mucous glands of the trachea in children: Quantitative studies . Anat Anz 126:146-160, 1970. 17. Hentzer E: Ultrastructure of the middle ear mucosa in secretory otitis media: I. Serous secretion . Acta Otolaryngol 73:394-401, 1972.Crossref 18. Tos M, Bak-Pedersen K: Intraepithelial glands in the human Eustachian tube . Arch Otolaryngol 96:546-552, 1972.Crossref 19. Bak-Pedersen K, Tos M: Density of mucous glands in various chronic middle ear diseases . Acta Otolaryngol 75:273-274, 1973.Crossref 20. Sade J: Middle ear mucosa . Arch Otolaryngol 84:137-143, 1966.Crossref 21. Hentzer E: Ultrastructure of the normal mucosa in the human middle ear, mastoid cavities, and Eustachian tube . Ann Otol Rhinol Laryngol 79:1143-1157, 1970. 22. Lim DJ, Hussl B: Human middle ear epithelium: An ultrastructural and cytochemical study . Arch Otolaryngol 89:835-849, 1969.Crossref 23. Tos M: Development of mucous glands in the human Eustachian tube . Acta Otolaryngol 70:340-350, 1970.Crossref 24. Tos M: Development of the tracheal glands in man . Acta Pathol Microbiol Scand , (suppl 185) , 1966. 25. Vered J, Eliezer N, Sade J: Biochemical characterization of middle ear effusions . Ann Otol Rhinol Laryngol 81:394-400, 1972.

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Feb 1, 1975

References