Abstract
Immunological responses fulfil a vital protective role in the middle ear cavity. This is most evident with the onset of bacterial or viral infections from the upper respiratory tract. On occasions, however, incomplete resolution of these infections occurs, and immune mechanisms may inadvertently cause or contribute to the development of secondary disorders. Commonest, and hence most important, of these conditions is otitis media with effusion. There is accumulating evidence to suggest that protective immune mechanisms may contribute to enhanced local bone resorption in acquired cholesteatoma, and the pathogenesis of otosclerosis in genetically susceptible individuals. In addition, `immune protection’ is an unwanted phenomenon when allograft tissues or synthetic materials are implanted during tympanomastoid reconstructive surgery, and may compromise functional results. This chapter presents an overview of the role of immune processes in these various middle ear disorders.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Lim DJ. Functional morphology of the lining membrane of the middle ear and Eustachian tube. Ann Otol Rhinol Laryngol. 1974;80 SuppI 11:1–22
Lim DJ, Bluestone CD, Klein JO, Nelson JD, eds. Recent advances in otitis media with effusion. Philadelphia: BC Becker Inc.; 1985
McGovern JP, Haywood Ti, Fernandes A. Allergy and secretory otitis media. J Am Med Assoc. 1967;200:124–8
Viscomi GJ. Allergic secretory otitis media: an approach to management. Laryngoscope. 1974;85:751–8
Phillips MJ, Knight NJ, Manning H, Abbott AL, Tripp WG. IgE and secretory otitis media. Lancet. 1974;2:1176–8
Bernstein JM, Tomasi TB, Ogra P. The immunochemistry of middle ear effusions. Arch Otolaryngol. 1974;99:320–6
Mogi G, Honjo S, Maeda S, Yoshida T, Watanabe N. Quantitative determination of secretory immunoglobulin A (SIgA) in middle ear effusions. Ann Otol Rhinol Laryngol. 1974;83:239–46
Liu YS, Lim DJ, Lang RW, Birck HG. Chronic middle ear effusions: immunochemical and bacteriological investigation. Arch Otolaryngol. 1975:101:278–86
Juhn SK, Giebink GS, Huff JS, Mills EL. Biochemical and immunochemical characteristics of middle ear effusions in relation to bacteriological findings. Ann Otol Rhinol Laryngol. 1989;89,Suppl 68:161–8
Mogi G, Maeda S, Umehara T, Fujiyoshi T, Kurono Y. Secretory IgA, serum IgA and secretory component in middle ear effusions. In: Lim DJ, Bluestone CD, Klein JO, Nelson JD, eds. Recent advances in otitis media with effusion, Philadelphia & Toronto: Decker BC; 1985:147–9
Freijd A, Oxelius VA, Rynnel-Dagoo B. A prospective study demonstrating an association between plasma IgG concentrations and susceptibility to otitis media in children. Scand J Infect Dis. 1985;17:115–20
Freijd A, Hammarstrom L, Persson MA, Smith CI. Plasma anti-pneumococcal antibody activity of the IgG class and subclasses in otitis-prone children. Clin Exp Immunol. 1984;56:233–8
Prellner K, Kalm O, Pedersen FK. Pneumococcal antibodies and complement during and after periods of recurrent otitis. Int J Pediatr Otorhinolaryngol. 1984;7:39–49
Siber GR, Schur PH, Aisenberg AC, Weitzman SA, Schiffman G. Correlation between serum 1gG2concentrations and the antibody response to bacterial polysaccharide antigens. N Engl J Med. 1980;303:178–82
Bernstein JM. Recent advances in immunologic reactivity in otitis media with effusion. J Allergy Clin Immunol., 1988;81:1004–9
Prellner K, Harsen G, Lofgren B et al. Responses to rubella, tetanus and diphtheria vaccines in otitis-prone and non-otitis-prone children. Ann Otol Rhinol Laryngol. 1990;628–32
Jorgensen F, Andersson B, Hanson LA et al. Gamma-globulin treatment of recurrent otitis media in children. Pediatr Infect Dis J. 1990;9:389–94
Richardson VF, Larcher VF, Price IF. A common congenital immunodeficiency predisposing to infection and atopy in infancy. Arch Dis Child. 1983;58:799–802
Super M, Thiel S, Lu J et al. Low levels of mannan binding protein underlay a common defect in opsonization. Lancet. 1989;1:1236
Prellner K. Complement and other amplification mechanisms. In: Bernstein JM, Ogra PL, eds. Immunology of the ear, New York: Raven Press 345–61
Takeuchi K, Saida S, Majima Y, Sakakura Y. The effect of middle ear effusions from children on in-vitro ciliary activity. Eur Arch Otorhinolaryngol. 1990;247:323–5
Palva T, Taskinen E, Hayry P. T lymphocytes in secretory otitis media. In: Veldman JE, McCabe BF, Huizing EH, Mygind N, eds. Immunology, autoimmunity, transplantation in otorhinolaryngology. Amsterdam & Berkeley: Kugler Publications; 1985:45–50
Cauwenberge PV, Plum J, De Smedt M. Analysis of T and B lymphocytes in middle ear effusions of children with OME. In: Immunobiology, histophysiology and tumour immunology in otolaryngology. Proceedings of the 2nd International Academic Conference, Utrecht. Amsterdam/Berkeley: Kugler Publications; 1987:247–52
Ogra PL, Tsutsumi H, Bernstein JM, Okamoto Y, Brodsky L. Influence of immune mechanisms on the natural history of otitis media. In: Immunobiology, histopathology and tumour immunology in otolaryngology. Proceedings of the 2nd International Academic Conference, Utrecht. Amsterdam/Berkeley: Kugler Publications; 1987:235–40
Sarkkinen HK, Halonen PE, Arstila PP et al. Detection of respiratory syncytial, parainfluenza type 2 and adenovirus antigens by radioimmunoassay and enzyme immunoassay on nasopharyngeal specimens from children with acute respiratory disease. J Clin Microbiol. 1981;13:256–65
Chonmaitree T, Howie VM, Truant AL. Presence of respiratory viruses in middle ear fluids with nasal wash specimens from children with otitis media. Paediatrics. 1986;77:698
Catanzaro A, Ryan AF, Robb J. Immune-mediated and non-specific inflammatory events in the middle ear. Clin Immunol Immunopathol. 1982;24:361–76
Ryan AF, Cleveland PH, Hartman MT, Catanzaro A. Humoral and cell-mediated immunity in peripheral blood following introduction of antigen into the middle ear. Ann Otol Rhinol Laryngol. 1982;91:70–5
Ryan AF, Catanzaro A, Wasserman SI, Harris JP. Secondary immune response in the middle ear: physiological, anatomical and immunological observations. Ann Otol Rhinol Laryngol. 1986;95:242–9
Suzuki M, Kawauchi H, Mogi G. Immune-mediated otitis media with effusion. Am J Otolaryngol. 1988;9:199–209
Veltri W, Sprinkle PM. Secretory otitis media: an immune complex disease. Ann Otol Rhino] Laryngol. 1976;85 Suppl 25:135–9
Mravec J, Lewis DM, Lim DJ. Experimental otitis media with effusion: an immune-complex mediated response. Trans Am Acad Ophthal Otolaryngol ORL. 1978;86:258–68
Palva T, Lehtinen T, Rinne J. Immune complexes in middle ear fluid in chronic secretory otitis media. Ann Otol Rhino] Laryngol. 1983;92:42–4
Bernstein JM, Shenkheim HA, Genco RJ, Bartholomew WR. Complement activity in middle ear effusions. Clin Exp Immunol. 1978;78:120–7
Meri S, Lehtinen T, Palva T. Complement in chronic secretory otitis media. Arch Otolaryngol. 1984;110:774–8
Watanabe N, Yoshimura H, Mogi G. Induction of antigen-specific-IgA forming cells in the middle ear mucosa. Arch Otolaryngol Head Neck Surg. 1988;114:758–62
Larrson A. Otosclerosis. A genetic and clinical study. Acta Otolaryngol (Stockh). 1960;Suppl 154:1–86
Morrison AW. Genetic factors in otosclerosis. Ann R Coll Surg. 1967;41:202–37
Wayoff M, Chobaut JC, Raffoux C, Bertrand D. Systeme HLA et otospongiose. J Fr Otolaryngol, 1979;28:299–301
Gregoriadis S, Zerras J, Varletzidis E, Toubis M, Pantazopoulos P, Fessas P. HLA antigens and otosclerosis. Arch Otolaryngol. 1982;108:769–71
Majsky A, Novotny Z, Fajstarr Y. HLA antigens and otosclerosis. Tissue Antigens. 1982;20:306–7
Dahlqvist A, Diamant H, Dahlqvist S, Cedergren B. HLA antigens in patients with otosclerosis. Acta Otolaryngol (Stockh). 1985;100:33–5
Anson BJ, Bast TH. The temporal bone and the ear. Springfield, IL: Charles C. Thomas; 1949
Nager GF. Histopathology of otosclerosis. Arch Otolaryngol. 1969;89:341–63
Arnold W, Plester DW. Vascular degeneration in otosclerosis and its influence on the mesenchymal reaction of the mucoperiosteum. Arch Otol Rhinol Laryngol. 1975;209: 127–43
Lim DJ, Robinson M, Saunders WH. Morphologic and immunohistochemical observation of otosclerotic stapes. Am J Otolaryngol. 1987;8:282–95
Yoo TJ, Stuart JM, Kong AH, Townes AS, Tomada K, Dixit S. Type II collagen autoimmunity in otosclerosis and Meniere’s disease. Science. 1982;217:1153–5
Huang C-C, Saporta D, Abramson M. Type H collagen-induced bone resorption in the temporal bone of rats: histological and immunohistochemical studies. Arch Otorhinolaryngol. 1985;242:183–8
Bretlau P, Balle V, Causse JB, Horsley-Petersen K, Sorensen CH, Solvsteen M. Is otosclerosis an autoimmune disease? In: Immunobiology, histophysiology and tumour immunology in otolaryngology. Proceedings of the 2nd International Academic Conference. Amsterdam: Kugler Publications; 1986:201–6
Harris JP, Woolf NK, Ryan AF. A re-examination of experimental Type II collagen autoimmunity: middle and inner ear morphology and function. Ann Otol Rhinol Laryngol. 1986;95:176–80
Schrader M, Poppendieck J, Plester D. Autoimmunologic aspects of otosclerosis. In: Immunobiology, histophysiology and tumour immunology in otolaryngology. Proceedings of the 2nd International Academic Conference, Utrecht. Amsterdam, Berkeley: Kugler Publications; 1987:433–4
Arnold W, Friedmann I. Otosclerosis - an inflammatory disease of the otic capsule of viral aetiology? J Laryngol Otol. 1988;102:865–71
McKenna MJ, Mills GB, Galey FR, Linthicum FH. Filamentous structures morphologically similar to viral nucleocapsids in otosclerotic lesions in two patients. Am J Otolaryngol. 1986;7:25–8
Gantz BJ, Maynard J. Ultrastructural evaluation of the biochemical events of bone resorption in human chronic otitis media. Am J Otol. 1982;3:279–83
Lim D, Saunders W. Acquired cholesteatomas. Ann Otol Rhinol Laryngol. 1972;81:1–12
Gantz BJ. Epidermal Langerhans cells in cholesteatoma. Ann Otol Rhinol Laryngol. 1984;93:150–6
Veldman JE. The Langerhans T-cell microenvironment in aural cholesteatoma. In: VeldmanJHuizing B, Mygind E, eds. Immunobiology, autoimmunity, transplantation in otorhinolaryngology. Amsterdam: Kugler Publications; 1985:69–79
Sauder DN, Dinarello CA, Morhenn VB. Langerhanscellproduction of interleukin-1. J Invest Dermatol. 1984;82:605–7
Veldman JE, Van Dijk CM, Visser CE, Huizing EH. Aural cholesteatoma and immunity. In: Veldman JE, McCabe BF, eds. Otoimmunology. Amsterdam/Berkeley: Kugler Publications; 1987:69–79
Gantz BJ, Hart MJ. Immunobiology of acquired aural cholesteatoma. In: Bernstein J, Ogra P, eds. Immunology of the ear. New York: Raven Press; 1987:391–402
House WF, Patterson ME, Linthicum FH. Incus homografts in chronic ear surgery. Arch Otolaryngol. 1966;84:148–53
Linthicum FH. Post-operative temporal bone histopathology. Laryngoscope. 1966;76: 1232–41
Kerr AG, Smyth GDL. The fate of transplanted ossicles. J Laryngol Otol. 1971;85:337–47
Kuijpers W, Van Den Broek P. Biological considerations for the use of homograft tympanic membranes and ossicles. Acta Otolaryngol. 1975;80:283–93
Veldman JE, Kuijpers W. Antigenicity of tympano-ossicular homografts of the middle ear: analyses of immune response to viable and preserved grafts in animal models. Otolaryngol Head Neck Surg. 1981;89:142–52
Frootko NJ. Immune responses in allograft tympanoplasty. In: Immunology, autoimmunity and transplantation in otorhinolaryngology. Proceedings of the 1st International Conference, Utrecht. Amsterdam: Kugler Publications; 1985:171–6
Marquet J. Ten years experience in tympanoplasty using homologous implants. J Laryngol Otol. 1976;90:897–905
Shimada T, Lim DJ. Distribution of ciliated cells in the human middle ear: electron and light microscopic observations. Ann Otol Rhinol Laryngol. 1972;81:203–11
Mogi G. Experimental otitis media with effusion. Immunobiology, histophysiology and tumour immunology in otolaryngology. Proceedings of the 2nd International Academic Conference, Utrecht. Amsterdam/Berkeley: Kugler Publications; 1987:253–63
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Brookes, G.B. (1994). Middle Ear Disorders. In: Scadding, G.K. (eds) Immunology of ENT Disorders. Immunology and Medicine Series, vol 23. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1436-3_12
Download citation
DOI: https://doi.org/10.1007/978-94-011-1436-3_12
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-4629-9
Online ISBN: 978-94-011-1436-3
eBook Packages: Springer Book Archive