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October 1988

Inflammatory Mediators in Chronic Otitis Media With Effusion

Author Affiliations

From the Departments of Pediatrics (Drs Skoner, Stillwagon, and Fireman, and Mr Tanner), and Otolaryngology (Drs Casselbrandt and Doyle), Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine.

Arch Otolaryngol Head Neck Surg. 1988;114(10):1131-1133. doi:10.1001/archotol.1988.01860220065025

• Otitis media with effusion (OME) is a common middle ear inflammatory disease in the pediatric population. This article determines concentrations of three functionally and metabolically distinct inflammatory mediators in middle ear effusions (MEE) and corresponding plasma of children with OME. One hundred two patients (mean age, 4.9 years) with persistent OME were studied. Middle ear effusions were collected from all subjects and plasma from a subset at the time of tympanostomy tube insertion. Histamine was assayed radioisotopically, 13, 14-dihydro-15-keto-prostaglandin F (stable PGF metabolite) by radioimmunoassay, and neutrophil chemotactic factor of anaphylaxis by modified Boyden chamber. Mean MEE levels of the mediators (39 ± 13 ng/mL, 462 ± 179 pg/mL, and 264% ± 57% positive control, respectively) were markedly higher than those of corresponding plasma (0.5 ± 0.1 ng/mL, 285 ± 127 pg/mL, and 47% ± 5% positive control, respectively). The mean histamine content of mucoid effusions (43.2 ± 56.9 ng/mL) was significantly higher than that of purulent (22.5 ± 10.5 ng/mL) and serous (17.9 ± 16.8 ng/mL) effusions. Higher histamine levels were observed in effusions positive for Haemophilus influenzae when compared with those with other pathogenic isolates. The high concentrations of these mediators in MEE and their potential for inducing or sustaining the inflammatory process supports a role in the pathogenesis of OME.

(Arch Otolaryngol Head Neck Surg 1988;114:1131-1133)