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Marrow-middle ear connections: a potential cause of otogenic meningitis

Kyoichi Terao1, Sebahattin Cureoglu, Patricia A Schachern

  • 1Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA. kyochankindai@yahoo.co.jp

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 22, 2010
PubMed
Abstract

Insights

Infants with otitis media may have more connections between bone marrow and the middle ear. This anatomical difference could increase their risk for childhood otogenic meningitis.

Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Anatomy

Background:

  • Otitis media and bacterial meningitis share a known causal relationship, but the exact mechanism remains unclear.
  • Infant temporal bone anatomy reveals direct connections between hematopoietic bone marrow and the middle ear, differing from adult anatomy.
  • These connections may represent a pathway for infection spread.

Purpose of the Study:

  • To investigate the hypothesis that connections between hematopoietic bone marrow and the middle ear contribute to childhood otogenic meningitis.
  • To compare the prevalence of these connections in infants with and without meningitis and otitis media.

Main Methods:

  • A quantitative analysis of temporal bones from 5 infants in three groups: meningitis with otitis media, controls without otitis media, and controls with otitis media (non-meningitis).
  • Microscopic evaluation of human fetal and infant temporal bones.
  • Investigated the correlation between unabsorbed mesenchyme and otitis media.

Main Results:

  • The frequency of hematopoietic bone marrow-middle ear connections was significantly higher in the meningitis group, followed by the otitis media control group, and then the healthy control group.
  • A more severe degree of unabsorbed mesenchyme was observed in the same order: meningitis group, otitis media control group, and healthy control group.

Conclusions:

  • The prevalence of connections between hematopoietic bone marrow and the middle ear is notably high in infants with meningitis and otitis media.
  • These anatomical connections in infants with otitis media may elevate the risk for developing otogenic meningitis.

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