A CYTOLOGICAL STUDY OF EFFUSIONS IN CHILDREN WITH OTITIS MEDIA WITH EFFUSION YUKIHIRO SOMEKAWA, M. D. and NOBORU YAMANAKA, M. D. Department of Otolary

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Transcription:

A CYTOLOGICAL STUDY OF EFFUSIONS IN CHILDREN WITH OTITIS MEDIA WITH EFFUSION YUKIHIRO SOMEKAWA, M. D. and NOBORU YAMANAKA, M. D. Department of Otolaryngology, Sapporo Medical College, Sapporo A cytological analysis in 330 samples of middle ear effusions (MEEs) from the children with otitis media with effusion (OME) was performed with the use of cytocentrifuge method. May- Giemsa stained smears were classified into five types on the bases of the inflammatory cellular patterns, i. e., neutrophil dominant type (N), mononuculear cell dominant type (M), mixed type (Mix), mucous and cellular remnant type (M. CR), and too few cells type (FC). And the cellular types such classified were compared with their clinical data in order to obtain the definitive information about the inflammatory state and process in the middle ear cavity (MIC). The results were as follows: 1) A large descrepancy was observed between the global appearance and cytological findings of the MEEs. 2) In acute group OME, almost sixty per cent of the MEEs showed (N) type smears. In chronic group, the percentage of (N) type smears were decreased to 23.5% and (M) type, (Mix) type, (M. CR) type, and (FC) type smears were increased to 18.5%, 14.5%, 31.2% and 12.4%, respectively. 3) On the other hand, in chronic group MEEs of cases who had a recent episode of acute exaservation showed (N) type smears in 55.6%. 4) Long term examination of smears in each case revealed the presence of continuous changes in the cytological patterns. From the results described above, the cytological analysis of MEEs may be one of the useful breakthrough in order to clarify the mechanism of chronicity of OME. Key words:

3) Lim DJ et al: Otitis media with effusion: cytological and microbiological correlates. Arch Otolaryngol 105: 404-412, 1979. 4) Bryan MP and Bryan WTK: The use of aural cytology in the diagnosis of various inflammations and malignant tumors. Acta Cytologica 14, 411-

417, 1970. 5) Bryan MP and Bryan WTK: Cytologic and immunologic response revealed in middle ear effusions, Ann Otol Rhinol Laryngol 85 (supple 25): 238-244, 1976. 6) Palva T et al: Protein and cellular pattern of glue ar secretions. Ann Otol Rhinol Laryngol e85 (supple 25): 103-109, 1976. 7) Palva T et al: Lymphocyte morphology in middle ear effusions. Ann Otol Rhinol Laryngol 89 (supple 68): 143-146, 1980. 8) Senturia BH et al: Studies concerned with tubotympanitis. Ann Otol Rhinol Laryngol 67: 440-467, 1958. 9) Senturia BH et al: Report of the AdHoc committee on definition and classification of otitis media with effusion. Ann Otol Rhinol Laryngol 89 (supple 68): 3-4, 1980. 17) Walter JB and Isreal MS: Chronic Inflammation, Chapt. 11 in Walter JB and Israel MS (ed): General Pathology, 2nd Edition. Chuechill, London, 1965, pp. 185-186. 20) Yamanaka N et al: Spontaneous DNA synthesis in tonsillar lymphocytes and its clinical implications. Acta Otolaryngol 96: 181-187, 1983. 21) Yamanaka N et al: Spontaneous DNA synthesis in adenoid lymphocytes of patients with otitis media with effusion. Acta Otolaryngol: in press. 13) Juhn SK et al: Pathogenesis of otitis media. Ann Otol Rhinol Laryngol 86: 481-492, 1977. 14) Hussel B and Lim DJ: Experimental middle ear effusions: an immunofluorescent study. Ann Otol Rhinol Laryngol 83: 334-342, 1974. 15) Walter JB and Israel MS: Blood Grouping and Blood Transfusion, Chapt. 53 in Walter JB and Israel MS (ed): General Pathology, 2nd Edition. Churchill, London, 1965, pp. 975-976.