Secretory otitis media. Pathology and pathogenesis related to clinical picture

Secretory otitis is divided into three stages, and from a description of the pathogenic processes taking place in each stage it is attempted to explain how secretion is generated, and why it stops. The initial stage is characterized by inflammatory changes by way of capillary dilatation and proliferation, lymphatic infiltration, increased goblet-cell density and formation of mucous glands; the secretion is exudative with admixture of mucus. The secretory stage is dominated by secretion of mucus from the metaplastic mucosa with extremely high density of goblet cells and glands. In the degenerative stage, the production of mucus abates because the goblet-cell density decreases, and the glands degenerate.