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L. G. HADJOPOULOS, M.D.; J. W. BELL, M.D.

Arch Otolaryngol. 1937;25(6):601-617.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The present study was undertaken to determine, if possible, the most common pathways by which ordinary pyogenic infection of the upper respiratory tract may reach the middle ear and the mastoid process.

Despite the common idea (prevailing hypothesis) that involvement of the middle ear and the mastoid is caused by the direct extension of infection from the nasopharynx through the eustachian tube ("the normal anatomic pathway"), we have collected sufficient evidence to consider the blood and lymph channels as the more direct and common pathways for such infections.

The hypothesis of direct extension, in our view, does not adequately account for the fact that cultures of material from the nasopharynx will invariably grow streptococci although the early serosanguineous transudate from the middle ear is sterile. Similarly, the hypothesis does not explain the presence of isolated areas of broken-down mastoid cells, usually those about the sinuses, without the presence of pus . . . [Full Text PDF of this Article]

Author Affiliations
NEW YORK

Footnotes
A preliminary report from the Department of Otolaryngology, Beth Israel Hospital (Dr. S. J. Kopetzky). Further studies are in progress.

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