There are of course other contributory causes. Chronic otitis media may be incriminated. Moreover, cases of acute suppuratory otitis media, inadequately treated, have been adding to the increasing numbers of 'secretory (mucoid) otitis media'. The role of the secretory epithelium of the eustachian tube must not be underestimated. Further investigations are required and our own investigations are going to be intensified to answer some of the remaining problems. It seems reasonable to conclude at this stage that the mucosal changes here described form an essential and important histopathological factor in the pathogenesis of mucoid secretory otitis media.
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