The Mucous Glands in Chronic Secretory Otitis Media

Abstract

From a patient with mild chronic secretory otitis media the mucous membrane of the osseous part of the Eustachian tube and the middle ear were removed in toto and stained by the PAS-alcian blue whole-mount method whereby the mucous glands and goblet cells stain selectively. This revealed a surprisingly large number of mucous glands as well as increased density and extent of goblet cells. The shape, structure, size, and distribution of the glands are described. In the osseous part of the Eustachian tube 135 glands were found, in the tympanic cavity 223, in the epitympanon 60, in the antrum 20, and in the mastoid process 50 glands, average density 0.9, 1.9, 1.4, 0.3, and 2.4 glands per square mm respectively. The glands were found to be in different secretory stages, 188 in an active, 102 in a transitional, and 198 in a degenerated stage, each showing its characteristics. All the glands are abnormal and responsible for the viscous mucous secretion which may be present in chronic secretory otitis media. The role of the mucous glands in the patho-genesis and course of chronic secretory otitis is discussed. It is pointed out that the symptoms are due to the secretory capacity of the mucous elements, tubal function, and the ciliary function of the epithelium.