Possible role of adenoid mast cells in the pathogenesis of secretory otitis media

The distribution of mast cells in the adenoidectomy specimens of 76 children with enlarged adenoids was studied. Forty of the patients had secretory otitis media; the remaining 36 had normally aerated middle ears. The mast cells were identified on the basis of the metachromatic staining of their cytoplasmic granules with toluidine blue. Patients with secretory otitis media had a twofold increase of their mast cell population compared to those without middle ear disease. Statistical analysis confirmed that the difference between the two groups is significant (p = .0001). The results of the study are consistent with the previous finding of increased histamine concentration in adenoids of children with secretory otitis media and lend support to the adenoid mediator release hypothesis, whereby the adenoid mast cells degranulate and release histamine and other inflammatory mediators that induce eustachian tube insufficiency and otitis media with effusion.