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Cytological and histopathological studies of otitis media with effusion
Abstract:
Middle ear fluid contains such cells as neutrophils, macrophages, and lymphocytes. There have been numerous reports dealing with these cellular components in the fluid. This study was undertaken to investigate interrelation between the type of predominant cells in the fluid and the stage of disease in adults and children. The study also included bacterial isolation from fluid for comparison of detection rates between adults and children, and microscopic examination of temporal bone from 2 adult patients with otitis media with effusion complicating tumors of head and neck. Thirty-two ears of adult patients and 40 ears of children both having received myringotomy were studied. The fluid specimens were obtained from middle ears examined microscopically with May-Giemsa stain and with alpha-Naphthyl butyrate esterase and Naphtohol AS-D chloroacetate double stains for identification of macrophages. Histopathological studies of the temporal bone were examined with hematoxylineosin stain. In adults, neutrophils were predominant in the fluid of 54.5% of subacute cases while the predominant cell type was macrophages in 45% of chronic cases. Neutrophils were the predominant type in 62.2% of children with chronic stage. Bacteria were demonstrated in 26.0% of the adult cases and in 21.6% of the children. By histopathological examination of the temporal bones, neutrophils were found in the fluid of case 1, and a large number of macrophages in the fluid and fibrosis of the tympanic cavity were found in case 2.
Insights
In adults with middle ear fluid, neutrophils dominate subacute stages, while macrophages prevail in chronic stages. In children, neutrophils are most common in chronic otitis media with effusion.
Area of Science:
- Otolaryngology
- Cell Biology
- Pathology
Background:
- Middle ear fluid (MEF) contains neutrophils, macrophages, and lymphocytes.
- Previous research has focused on cellular components in MEF.
- The relationship between predominant cell types in MEF and disease stage requires further investigation.
Purpose of the Study:
- To investigate the interrelation between predominant cell types in MEF and disease stage in adults and children.
- To compare bacterial isolation rates in adult and pediatric MEF.
- To examine temporal bone histopathology in adult cases of otitis media with effusion (OME) complicating head and neck tumors.
Main Methods:
- Analysis of MEF from 32 adult and 40 pediatric ears undergoing myringotomy.
- Microscopic examination of MEF using May-Giemsa and specific macrophage stains (alpha-Naphthyl butyrate esterase, Naphtohol AS-D chloroacetate).
- Histopathological examination of temporal bones from two adult patients using hematoxylin-eosin stain.
Main Results:
- In adults, neutrophils predominated in subacute MEF (54.5%), and macrophages in chronic MEF (45%).
- In children with chronic OME, neutrophils were the predominant cell type (62.2%).
- Bacterial detection rates were 26.0% in adults and 21.6% in children. Temporal bone studies revealed neutrophils in one case and macrophages with fibrosis in another.
Conclusions:
- Cellular composition of MEF correlates with disease stage in both adult and pediatric OME.
- Bacterial presence is comparable between adult and pediatric cases.
- Histopathological findings highlight inflammatory and cellular responses in complex OME cases.