Smoking and middle ear ciliary beat frequency in otitis media with effusion

The middle ear mucociliary system has been shown to play an important role in clearing middle ear effusions. There is conflicting epidemiological evidence, however, as to whether exposure to tobacco smoke plays a significant role in persistence of middle ear effusion in patients with otherwise normal mucociliary function. Samples of middle ear mucosa from 33 patients with persistent otitis media with effusion (OME) were taken at myringotomy, together with corresponding nasal brushings. The aim of this study was to observe the mean ear ciliary beat frequency (CBF) and to compare it with nasal ciliary activity. Nasal brushings were collected from 33 age and sex matched non-smoking controls with no history of nasal atopy or topical nasal treatment. Ear CBF in OME was significantly reduced in comparison to paired nasal samples (p < 0.001). Ear CBF in adult OME patients who smoked or in children who were passive smokers was significantly less than in patients who were not exposed to cigarette smoke (p < 0.01). This study indicates that impaired ciliary function due to tobacco smoke exposure is an aetiological factor in persistent OME.