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77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

Histomorphological Study of Lymphoid Tissue in the Eustachian Tube and Middle Ear in the Presence of Different Effusions

Histomorphologische Untersuchung der Verteilung von lymphatischem Gewebe im Mittelohr und der Tuba Eustachii bei verschiedenen Lumeninhalten

Meeting Abstract

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  • corresponding author A. M. Paul - Universitätskrankenhaus Hamburg-Eppendorf, Hamburg, Germany
  • R. Leuwer - Klinikum Krefeld, Krefeld, Germany
  • M. Sanchez-Hanke - Universitätskrankenhaus Hamburg-Eppendorf, Hamburg, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno052

The electronic version of this article is the complete one and can be found online at:

Published: September 7, 2006

© 2006 Paul et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: MALT (mucosa associated lymphoid tissue) of the middle ear mucosa and the Eustachian Tube were found as lymphoid follicles.

The aims of this study were, firstly, to correlate the presence of these lymphoid follicles to an obstruction of the tube lumen, and secondly to the type of effusion in the lumen of the Eustachian Tube and the middle ear.

Methods: We examined 90 temporal bones, looking at the luminal obstruction, the type of effusion and the presence of lymphoid follicles.

Results: The results showed that in the cases with an obstructed lumen, follicles were more likely to be found than if the lumen was fluid-free. In those cases showing no obstruction only 8.8% of the Eustachian Tubes and 2.1% of the middle ears showed follicles. With lumens partially obstructed by fluid, they were observed in 35.0% (tube) and 16.1% (middle ear) of cases, in cases with the lumen completely filled with effusion 40% (tube) and 42.9% (middle ear).

Follicles were observed more often if a serous or purulent effusion was found. In those tubes containing a serous fluid, they were present in 52.6%, while this number decreased to 6.3% in its absence. Similarly, while only 9.4% of cases without purulent fluid showed follicles, this number increased to 41.2% in its presence. In the middle ear, 26.9% of cases showed follicles if serous fluid was present. If not they were found in only 1.7%; the numbers for purulent fluid being 25.0% and 3.2% respectively. A mucous effusion seemed to have no impact on the incidence of follicles.

Given the fact that lymphoid follicles indicate a permanent irritation of the mucosa by inflammatory stimuli, it may be seen that different types of effusion occur during the progression of mucosal inflammation to a chronic state. Associated with these different effusions, different incidences of lymphoid follicles may be observed.