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Extensive variations in nasal mucosa in infants with and without recurrent acute otitis media. A scanning
F Jørgensen1, B Petruson, H A Hansson
1Department of Histology, University of Göteborg, Sweden.
Abstract:
Biopsy specimens of the nasal mucosa from the inferior turbinate of infants aged 2 to 26 months were examined by scanning electron microscopy. The specimens were obtained from 23 clinically healthy infants and compared with those from 43 infants with recurrent acute otitis media (RAOM). Potentially pathogenic bacteria were isolated from 61% of the control subjects and 90% of those with RAOM. Infants with RAOM had about as extensive alterations as the healthy ones. A single healthy child and one with RAOM had what was interpreted as a normal nasal mucosa; all others showed reduced frequencies of ciliated cells, deformation of cilia, extensive loss of normal mucosal epithelium, and metaplasia in their nasal epithelial lining. Severely damaged area could be seen close to more normal ones. Nasal mucosa in clinically healthy infants rarely had a normal appearance, probably due to frequent infections and the fairly long time needed for the repair process. We proposed that the high frequency of damaged, incompletely healed nasal mucosa may constitute an important factor with regard to the susceptibility to further infections.
Insights
Infant nasal lining damage is common, even in healthy children, and may increase susceptibility to infections like recurrent acute otitis media (RAOM). This suggests impaired healing contributes to repeated illness.
Area of Science:
- Otorhinolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Recurrent acute otitis media (RAOM) is a common childhood infection.
- The nasal mucosa plays a critical role in respiratory health and defense against pathogens.
- Understanding the nasal mucosal state in infants with RAOM is crucial for identifying predisposing factors.
Purpose of the Study:
- To investigate the ultrastructural changes in the nasal mucosa of infants with RAOM.
- To compare the nasal mucosa of infants with RAOM to that of healthy controls.
- To explore the potential link between nasal mucosal integrity and susceptibility to infections.
Main Methods:
- Scanning electron microscopy was used to examine nasal mucosal biopsy specimens.
- Specimens were obtained from clinically healthy infants and infants diagnosed with RAOM.
- Bacterial cultures were performed to identify potentially pathogenic microorganisms.
Main Results:
- Potentially pathogenic bacteria were isolated from 61% of controls and 90% of RAOM infants.
- Nasal mucosa alterations, including reduced ciliated cells and epithelial damage, were prevalent in both groups.
- A normal nasal mucosa was rarely observed; most infants exhibited varying degrees of damage and incomplete healing.
Conclusions:
- Infants, including those considered healthy, frequently present with damaged nasal mucosa.
- The high prevalence of incompletely healed nasal mucosa may be a significant factor in susceptibility to recurrent infections.
- Further research into nasal mucosal repair mechanisms is warranted to understand and potentially mitigate recurrent infections.