EVERY EAR SURGEON is familiar with the great variety of changes of the promontory mucosa which are associated with chronic ear disease. A thin, pink mucosa is generally seen only in connection with epitympanic processes. In diseases of the middle ear proper, the mucosa is often thick and edematous, there may be granulations and polyps with occlusion of the normally open recesses, or the middle ear may be filled with cholesteatoma.
The microscopic changes due to infection in the tympanum and in the mastoid bone were thoroughly described in the early part of this century.1 Particularly in the tympanum, organization of the fibrin-rich exudate was found to lead to obliteration of many recesses of the cavity. As pointed out by Ojala,2 however, fibrin is scarcely the decisive factor, the prerequisite being rather that inflammatory damage to the epithelium occur and pave the way for tissue proliferation. The granulation
Palva T, Palva A, Dammert K. Middle Ear Mucosa and Chronic Ear Disease. Arch Otolaryngol. 1968;87(1):3–11. doi:10.1001/archotol.1968.00760060005003