Silent otitis media

M. M. Paparella, D. Shea, W. L. Meyerhoff, M. V. Goycoolea

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Abstract

There is a traditional view that chronic otitis media and chronic mastoiditis must exist in the presence of a tympanic membrane perforation. Based on a human histopathological study of 123 temporal bones with otitis media out of 333 temporal bones with all forms of otitis media pathology, only 24 patients (36 ears) had symptoms of otolgical disease recorded on their charts and only 19.% of these had an associated tympanic membrane perforation. Unsuspected findings of chronic otitis media (active or inactive) are occasionally confirmed at exploratory tympanotomy. Such quiet chronic pathological findings in the middle ear have occurred in association with endolymphatic hydrops and cochlear end organ lesions suggesting the possibility that silent chronic otitis media may help explain sensorineural hearing loss, vertigo, and tinnitus for certain patients. We put forth the hypothesis that clinically undetectable silent otitis media in neonates and infants might help explain why certain children are otitis media prone. Our otopathology laboratory includes 111 ears harvested from neonates and infants (average age 8 months). Histological analysis revealed normal findings in some, whereas significant numbers of others show all forms otitis ototis media, including purtulent otitis media, chronic otitis media, serous otitis media, and mucoid otitis media, with occasional overlap of types. Clinical implications will be discussed with emphasis on silent otitis media and its relationship to the pathogenesis of otitis and silent chronic otitis media and its possible role in causing insidious labyrinthine changes. A significant outcome of this study was the marked degree of unresolved mesenchyme in the clinically manifest otitis media group or silent otitis media group as compared to a control group. This association and role of mesenchyme is discussed relative to the pathogenesis of infantile otitis media.

Original languageEnglish (US)
Pages (from-to)1089-1098
Number of pages10
JournalLaryngoscope
Volume90
Issue number7 I
Publication statusPublished - 1980

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ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Paparella, M. M., Shea, D., Meyerhoff, W. L., & Goycoolea, M. V. (1980). Silent otitis media. Laryngoscope, 90(7 I), 1089-1098.