Ultrastructural pathology of the middle ear mucosa in otitis media with effusion.

To elucidate the histopathological features of the middle ear mucosa in otitis media with effusion (OME), 33 specimens were obtained from OME patients (28 from children and 5 from adults) at the time of the ventilation tube insertion, and examined by light- and electron-microscopy. The mucosa from both pediatric and adult OME patients with glue effusion consisted mostly of non-ciliated cells containing numerous low electron-dense granules with or without a core, and many macroapocrine sections were observed on the apical surface of the cells. The mucosa with mucoid effusion showed various secretory activity, but macroapocrine secretions were rarely found. The intercellular space was intact and the junctional complex was well preserved. In serous otitis cases, the epithelia consisted mostly of cuboid ciliated cells and non-ciliated cells without definite secretory activity. But the intercellular space became widened and the junctional complex was occasionally damaged, indicating that the epithelium was quite permeable. We concluded that there was no significant histopathological difference between the OME mucosa of children and that of adults, although the nature of the effusion was closely correlated with the morphological features of the epithelial linings.