Otitis media and the immotile cilia syndrome

Abstract

The immotile cilia syndrome appears to be a congenital defect in the ultrastructure of cilia that renders them incapable of movement. Respiratory tract cilia and sperm are predominantly affected. Bronchiectasis, sinusitis and male sterility are the main clinical findings. Situs inversus may be found. To these findings can be added otitis media. The defect appears to be a complete or partial absence of dynein arms which are believed to be essential for generating movement of cilia or sperm tails. Six patients suspected of having immotile cilia were compared to six patients in a control group. In affected patients, no cilia movement in the middle ear or nasopharynx was observed using the operating microscope. Electron microscopy of cilia from the mucosa of the middle ear and nasopharynx appeared to confirm the ultrastructural defect in two of six patients suspected of having the syndrome.

Management of otitis media with effusion in children with primary ciliary dyskinesia: A literature review

“…These include mucociliary clearance, osmotic gradients, active sodium transport and a Eustachian tube pump [35]. It is thought that ciliary activity is important for the clearance of middle ear mucus and debris [36] and that ciliary dysfunction may be a contributor to the pathogenesis of OME. Hence, the interest in OME in PCD which may provide further clues its pathogenesis.…”

“…In 1967, the movement of instilled carbon particles was observed in the middle ear of patients with dry perforations [37]. Subsequently, it is now known that motile cilia in the ear are found in the anterior hypotympanum and anterior part of the middle ear near the Eustachian tube opening [36]. Further, the ciliary beat frequency has been noted to be significantly reduced in patients with a history of OME compared with those without [38].…”

“…It is thought that in PCD, VT insertion alters the middle earnasopharyngeal pressure relationship, allowing drainage of middle ear secretions via the Eustachian tube, despite the abnormal mucociliary transport system [36]. VT also increase the oxygen tension in the middle ear which may reduce the higher number of secretory cells found in the middle ear mucosa in OME and may also reduce the biofilm load [39].…”

Altered Ciliary Substructure in the Endosalpinx in Women using an IUCD

“…Cilia in general are oriented parallel t o their axonemata, although ciliar disorientation can occasionally be found (16,17). Disorientation is a feature of primary ciliary dysfunction (7) and is also found in infected mucosa in humans (18).…”

Immune Complexes in the Middle Ear Fluid and Adenoid Tissue in Chronic Secretory Otitis Media

“…With some rare exceptions the cellmediated immune response, in which the T cells are involved, is also normal (Palva et al, 1980). There is a small group of cases in which recurrent or persistent disease is due to ciliary immotility and the dynein arms of the cilia are congenitally absent (Jahrsdoerfer et al, 1979). In the majority of cases, however, the disease is local and the underlying pathogenic mechanism remains unclear.…”