Abnormalities of cilia in the middle ear in chronic otitis media.

We studied the fine structure of nasal and middle ear mucosa in 18 patients with chronic otitis media, comparing them with ten age-matched control patients. Electron microscopy revealed no single fundamental defect of cilia in the tissue samples; however, patients with chronic otitis media had a significantly higher incidence of abnormal cilia in the middle ear without correlating abnormalities of nasal cilia. These findings indicated that ciliary anomalies, including deletion of ciliary microtubules, presence of supernumerary tubules, and fusion of cilia, occur as a result of infection or inflammation. Such abnormalities would impair normal mucociliary clearance and exacerbate clinical complications.