Adenoids and otitis media with effusion: A morphological study

• Published in: American journal of otolaryngology Vol. 19; no. 4; pp. 244 - 250
• Main Authors: Kiroǧlu, Mustafa Mete, Özbilgin, Kemal, Aydoǧan, Barlas, Kiroǧlu, Fikret, Tap, Özgul, Kaya, Mehmet, Özsahinoglu, Can
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.1998; Elsevier
• Subjects: Adenoidectomy; Adenoids - pathology; Adenoids - ultrastructure; Antigen-Presenting Cells - ultrastructure; Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Humans; Immunoenzyme Techniques; Immunohistochemistry; Male; Medical sciences; Microscopy, Electron; Non tumoral diseases; Otitis Media with Effusion - immunology; Otitis Media with Effusion - pathology; Otitis Media with Effusion - surgery; Otorhinolaryngology. Stomatology; Statistics, Nonparametric; Human; Effusion; Immunocytochemistry; Middle ear disease; Etiopathogenesis; Exploration; Bright field microscopy; Electron microscopy; Enzyme immunoassay; Adenoidectomy; Pathology; Surgery; ENT disease; Otitis media; Pharynx disease; Adenoid enlargement; Child; Comparative study; Hypertrophy
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/S0196-0709(98)90126-0

Purpose: Adenoidectomy, especially for the treatment of suppurative otitis media, has been used for a very long time. In this study, the role of adenoids in the origin of otitis media with effusion was investigated by using light microscopy, immunocytochemistry, enzymechemistry, and electron microscopy. Materials and Methods: A group of 28 children with otitis media with effusion (OME) was identified. Ages ranged from 3 to 12 years. A control group of 10 age-matched children without any middle ear and upper respiratory tract infection served as the basis for comparison. Specimens obtained at surgeries from both groups were divided into groups for light microscopy, immunocytochemistry, enzyme cytochemistry, and electron microscopy and then all were examined blindly. Also, quantitative analysis of antigen-presenting cells was performed blindly on 10 patients and 10 controls. Results: There was an increase in the number of lymphocytes, mast cells, plasma cells, macrophages, dendritic cells, and M cells in the adenoids of patients with OME when compared with the normal cases. Stratified squamous epithelial areas, collagenous fibers, and fibrocytes were also increased in the patient group. Antigen-presenting functions of epithelial cells are shown by major histocompatibility complex (MHC) class II positivity of some ciliated-columnar epithelial cells in the patient group. Conclusion: Adenoid tissues of patients with OME in this study seem to be infectious foci, aggravating immune reactions, which might attack the middle ear through an ascending route.