Abstract
Objectives
Otitis media causes labyrinthine changes and subsequent sensorineural hearing loss. The aim of this histopathologic study was to evaluate the extension of inflammation to the inner ear and its effects.
Methods
Out of 614 temporal bones with otitis media, 47 (30 cases) with chronic and 35 (21 cases) with purulent were selected for histopathologic study. Subjects with a history of acoustic trauma, head trauma, ototoxic drugs and other otologic and systemic diseases affecting the inner ear were excluded. The pattern of labyrinthine inflammation was classified as localized purulent, localized serous, generalized seropurulent and generalized serous. Inner ear findings were compared to age-matched controls.
Results
19% of temporal bones with chronic and 9% of temporal bones with purulent otitis media showed labyrinthine inflammatory changes. In chronic otitis media, inflammatory changes were: 56% localized purulent; 22% localized serous; 11% generalized seropurulent; and 11% generalized serous. Inflammatory changes in temporal bones with purulent otitis media included: 67% localized purulent; and 33% generalized seropurulent. Pathological findings included: serofibrinous precipitates and inflammatory cells in the scala tympani of basal turn and cochlear aqueduct; significant decrease in area of stria vascularis (p = 0.033); and loss of hair cells in the organs of Corti. No significant difference was found in area of spiral ligament area or number of fibrocytes in diseased and control bones.
Conclusions
Middle ear/inner ear interaction in otitis media can result in labyrinthine inflammation and cochlear damage. Early diagnosis and treatment of otitis media is important in preventing inner ear damage.
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