Cytological and histopathological studies of otitis media with effusion.

Middle ear fluid contains such cells as neutrophils, macrophages, and lymphocytes. There have been numerous reports dealing with these cellular components in the fluid. This study was undertaken to investigate interrelation between the type of predominant cells in the fluid and the stage of disease in adults and children. The study also included bacterial isolation from fluid for comparison of detection rates between adults and children, and microscopic examination of temporal bone from 2 adult patients with otitis media with effusion complicating tumors of head and neck. Thirty-two ears of adult patients and 40 ears of children both having received myringotomy were studied. The fluid specimens were obtained from middle ears examined microscopically with May-Giemsa stain and with alpha-Naphthyl butyrate esterase and Naphtohol AS-D chloroacetate double stains for identification of macrophages. Histopathological studies of the temporal bone were examined with hematoxylineosin stain. In adults, neutrophils were predominant in the fluid of 54.5% of subacute cases while the predominant cell type was macrophages in 45% of chronic cases. Neutrophils were the predominant type in 62.2% of children with chronic stage. Bacteria were demonstrated in 26.0% of the adult cases and in 21.6% of the children. By histopathological examination of the temporal bones, neutrophils were found in the fluid of case 1, and a large number of macrophages in the fluid and fibrosis of the tympanic cavity were found in case 2.