CHRONIC otitis media in the American Indian has long been recognized as a major health problem. In a previous report it was shown that 8.3% of the population of an Apache community in Eastern Arizona had a dry or wet perforation of one or both ears, and that an additional 13% had a healed perforation or tympanosclerosis as evidence of old infection.1 Further examination of these patients, especially the children, reveals chronic mucoid rhinorrhea, shrunken, pale nasal mucosa, and an insignificant amount of lymphoid tissue in the nasopharynx. These children also experience frequent bouts of diarrhea and pneumonia. Since lymphoid hypertrophy is usually considered part of the normal immunologic response in children, lack of adenoid enlargement combined with the recurrent respiratory and gastroenteric infections raise the possibility of an immunologic deficit.
The "antibody deficiency syndrome" has become a subject of increasing interest in recent years and was the topic
Zonis RD. Chronic Otitis Media in the Southwestern American Indian: II. Immunologic Factors. Arch Otolaryngol. 1968;88(4):366–369. doi:10.1001/archotol.1968.00770010368007
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