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Nadir Yildirim, MD; Michihiko Sone, MD; Cemil Mutlu, MD; Patricia A. Schachern, MD; Michael M. Paparella, MD; Chap T. Le, PhD

Arch Otolaryngol Head Neck Surg. 2000;126:75-78.

Objectives  To investigate the lower than expected incidence of otitis media in patients with cystic fibrosis (CF) through histopathologic evaluation of temporal bones and to document pathologic findings in the inner ears of patients with CF who received long-term administration of antibacterial and diuretic agents.

Design  Clinical records of patients who died of CF were reviewed. Their temporal bones were sectioned, stained with hematoxylin-eosin, and examined histologically. Additional sections were stained with Alcian blue and periodic acid–Schiff for comparison of goblet cell densities from middle ears and auditory tubes of patients with CF with those of control temporal bones. Results were analyzed using the t test.

Subjects  Twenty-one temporal bones from 11 patients with CF and 13 bones from 8 age-matched patients without CF were selected.

Results  All temporal bones with CF had well-pneumatized mastoids. Temporal bones from 2 patients (3 ears) revealed histological findings of chronic otitis media with effusion. There was a statistically significant reduction in the density of goblet cells in the medial (P=.002) and lateral (P=.05) walls in patients with CF who had no otitis media histologically compared with control temporal bones. Two patients with CF who had otitis media had increased densities of goblet cells. Inner ear damage, due to ototoxic drugs, was seen in most of the temporal bones from patients with CF.

Conclusion  Low densities of goblet cells in temporal bones with CF may contribute reduced amounts of viscous mucus, which can lead to a low incidence of otitis media.

From the Department of Otolaryngology, University of Minnesota, and the Otitis Media Research Center (Drs Yildirim, Sone, Mutlu, and Paparella and Ms Schachern); the International Hearing Foundation (Drs Yildirim, Sone, Mutlu, and Paparella); the Minnesota Ear Head and Neck Clinic (Dr Paparella); and the Division of Biostatistics, University of Minnesota School of Public Health (Dr Le), Minneapolis, Minn. Ms Schachern is now with the Otopathology and Molecular Biology Laboratory, Lions Research Laboratories, Minneapolis.

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