Immunologic aspects of otitis media with effusion.

In order to understand the mechanism involved in otitis media with effusion (OME), we have studied middle ear effusions (MEE) immunochemically, and experimental otitis media in guinea pigs and chinchillas. The results indicated: (1) that serous MEE are a mixture of normal middle ear secretions and transudates from serum, while mucoid MEE are the results of enhanced epithelial secretory activity and the transudates; (2) that mucosal immunity acts in middle ears affected by OME; and (3) that the middle ear is an organ capable of responding immunologically to antigenic substances. However, the normal, and developing, middle ear has a poorly developed mucosal immune system. It can be said that the middle ear is a potential site of immunological activity during infection. The poorly developed immune system is thought to be one of the factors in the infection proneness of the middle ear that leads to OME. Results of IgE study of MEE failed to support the concept that allergy is a major causative factor of OME.