Immune Complexes in the Middle Ear Fluid and Adenoid Tissue in Chronic Secretory Otitis Media

Abstract

Specimens of middle ear effusion and adenoid tissue were studied for bacteria and pneumococcal capsu-lar antigen in 107 patients with secretory otitis media. 120 of 163 middle ear effusion samples (73.6%) were negative on bacterial culture. Hemophilus influenzae was present in 9.2% and Streptococcus pneurnoniae in 1.8%. Hemo philus influenzae was cultured from 44.8% and Strepto coccus pneurnoniae from 35.5% of 107 adenoid tissue specimens. Free pneumococcal capsular antigen was demonstrated in 10.4% of the middle ear fluids and this figure rose to 23% when antigen was liberated from the immune complexes by heating. The corresponding figures for adenoid tissue suspension were 27.1 % and 39%. The adenoid tissue or the lymphoid tissue of the entire oro-pharynx could act as the source of antigen which could maintain immune complex disease in some patients suffer ing from secretory otitis media.