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January 1992

Bacterial Tympanogenic Labyrinthitis, Meningitis, and Sensorineural Damage

Author Affiliations

From the University of Minnesota Otitis Media Research Center, Minneapolis (Ms Schachern and Drs Paparella, Sano, and Duvall); and the Department of Biological Sciences, Mankato (Minn) State University (Dr Hybertson).

Arch Otolaryngol Head Neck Surg. 1992;118(1):53-57. doi:10.1001/archotol.1992.01880010057016

• Pathologic changes (sensorineural hearing loss, labyrinthitis, meningitis) can follow otitis media. Various macromolecular substances demonstrably enter the inner ear via the round window membrane, but its permeability to bacteria is less known. We inoculated Streptococcus pneumoniae type 7F bilaterally into the middle ears of two groups of chinchillas, with and without grafted round window membranes. Inner ears of inoculated animals were observed by light and electron microscopy. None with continuous grafts had labyrinthitis. Bacteria penetrated all three layers of nongrafted round window membranes and into all cochlear turns, entering Schuknecht's channels and following neuronal pathways; nerves were often degenerated, hair cells were damaged or missing, and the stria vascularis was edematous and hemorrhagic. The neural damage suggests a mechanism for the hearing loss that can follow otitis media. Absence of labyrinthitis and meningitis in grafted animals suggests a tympanogenic pathway for the bacteria.

(Arch Otolaryngol Head Neck Surg. 1992;118:53-57)

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