Tonnaer Edith L G M, Ingels Koen J A O, Rijkers Ger T, Curfs Jo H A J
Department of Otorhinolaryngology, University Medical Center St. Radboud, Nijmegen, The Netherlands.
Laryngoscope. 2003 Feb;113(2):322-7. doi: 10.1097/00005537-200302000-00023.
OBJECTIVES/HYPOTHESIS: The observation that during otitis media many different types of micro-organisms have been cultured from effusions indicate that, once present in the middle ear cavity, most types of micro-organisms are able to trigger an inflammatory reaction leading to otitis media. The present study was designed to determine the middle ear response after injection of different substances into the middle ear cavity.
To determine whether and to what extent an inflammatory response of the middle ear depends on the entering agent, the response in the tympanic cavity was studied by otomicroscopy and histological examination after inoculation of various substances.
Lewis rats were inoculated in transtympanic fashion either with live or heat-killed bacteria (pathogenic and nonpathogenic), Keyhole limpet hemocyanin, active charcoal, or saline. The mucosal response of the challenged middle ears was studied histologically.
Irrespective of the inoculated substance, no essential differences in the mucosal response were found. The intensity of the inflammatory response was greater when live bacteria were inoculated.
The present study demonstrates that any substance reaching the middle ear cavity is likely to induce otitis media. These observations emphasize the role of the eustachian tube as "porte d'entrée" in the pathogenesis of this disorder. Determination of specific aspects of the eustachian tube involved in protection or in facilitating bacterial translocation will be important for the understanding of the pathogenesis of otitis media and the subsequent development of new therapeutic strategies. In addition, elucidation of bacterial factors involved in the process of colonization and translocation will be of equal importance.
目的/假设：中耳炎积液中培养出多种不同类型微生物这一观察结果表明，一旦进入中耳腔，大多数类型的微生物都能够引发导致中耳炎的炎症反应。本研究旨在确定向中耳腔内注射不同物质后中耳的反应。
为了确定中耳的炎症反应是否以及在多大程度上取决于进入的物质，在接种各种物质后，通过耳显微镜检查和组织学检查研究鼓室的反应。
将活的或热灭活的细菌（致病性和非致病性）、匙孔血蓝蛋白、活性炭或生理盐水经鼓膜途径接种到Lewis大鼠体内。对受攻击的中耳的黏膜反应进行组织学研究。
无论接种何种物质，黏膜反应均未发现本质差异。接种活细菌时炎症反应强度更大。
本研究表明，任何进入中耳腔的物质都可能诱发中耳炎。这些观察结果强调了咽鼓管在该疾病发病机制中作为“入口”的作用。确定咽鼓管在保护或促进细菌移位方面所涉及的具体方面，对于理解中耳炎的发病机制以及随后新治疗策略的开发至关重要。此外，阐明参与定植和移位过程的细菌因素同样重要。
