Secretory Otitis Media and the Nature of the Mucociliary System

Abstract

Secretory otitis media is essentially a postinflammatory reaction of the middle ear, and involves excess mucus production by the middle ear lining. This lining consists of a mucociliary system, and in analogy to situations in other respiratory epithelia, its clearance action is deficient in S.O.M. Thus, the nature and function of the mucociliary system and its relation to factors such as ventilation of the middle ear are key questions in this disease. Observations on the clearance action of the mucociliary system in animals indicate the role of mucus as a coupling agent translating ciliary beat into effective clearance. Further observations on the nature of mucus suggest the specific properties, making it perform this function, as being mainly due to the crosslinked or entangled hydrophilic glycoproteins. The existence of such a network may impart to the material both its unique rheological characteristics and the solubility behaviour necessary for its specified role. It is suggested that a possible reason for clearance failure in pathological situations is an alteration in the macromolecular structures and thus in the ability of the mucus to perform as in normal systems.