Histopathology of Otitis Media in Infants with Cleft and High-Arched Palates

Abstract

The middle ear and the bony and cartilaginous portions of the eustachian tube (ET) were studied histopathologically in 20 temporal bones from 19 infants, aged 45 minutes to 12 months. Otitis media (OM) was observed in 17 of 20 bones, and 16 bones with OM had an effusion. Otitis media was more severe in the ears of cleft palate infants compared to those with high-arched palates. Inflammation was present in the bony portion of the ET in 15 of 17 temporal bones with OM, but appeared to be less marked than that present in the middle ear. In addition, inflammation of the cartilaginous portion of the ET appeared to be less severe than in its bony portion. Inflammation of the middle ear and the ET appeared to be more pronounced in older infants, particularly in those with cleft palates.

Cytokine Expression in Experimental Chronic Otitis Media With Effusion in Mice

“…However, degeneration of the middle ear mucosa with mononuclear cell infiltration was found in the endotoxin group but not in the control group. In a human study, Kitajiri et al 7 showed the histopathological appearance of OME in infants to be characterized by the formation of pseudostratified, cuboidal, or cylindrical epithelium in the middle ear mucosa. In addition, mononuclear cell infiltration was found in the ET of patients with OME, particularly in the pharyngeal half of the cartilaginous portion of the ET, and was increased by repeated infection 8 .…”

New Paradigms in the Pathogenesis of Otitis Media in Children

“…Children with craniofacial anomalies, such as cleft palate and Trisomy 21, are at increased risk of middle ear disease due to further ET compromise (34–37). Histopathology studies have reported deformed ET cartilage (38) and high incidence of OM (36) in patients with cleft palate.…”

Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004

“…Other contributions from Sando's laboratory were related to the pathological changes of the eustachian tube‐middle ear in individuals with cleft palate and high arched palate, 45 Down syndrome, 41 congenital syndromes, 46,47 chromosomal abnormalities, 48,49 advanced malignant tumors of the head and neck with involvement of the paratubal structures, 22 carcinoma of the oropharynx, 50 lymphoma invading the tensor veli palatini muscle implicating functional obstruction, 51 chronic renal failure, 52 and the occurrence of mucosa‐associated lymphoid tissue in the middle ear and the eustachian tube, possibly related to otitis media 53 …”