title: [Pathogenic immune factors in recurrent mucous tympanic effusion in children].
abstract: In children with recurrent secretory otitis media (SOM) a mechanical malfunction of the Tuba Eustachii (by adenoids, myogenous palatotubal insufficiency, persistent cartilaginous collapse of the tube) should be taken into consideration as well as immunological factors of the lymphatic structures of the pharynx which may influence the tubotympanal mucosa. The pharyngeal tonsil and the tubotympanal mucosa are part of the immune system of the mucosa which itself has a regulating immunological function and importance as do the central and peripheral lymphatic organs. The lymphatic ring of Waldeyer regulates the reactivity of the tubotympanal mucosa in a similar way as the plaques of Peyer do control and influence immunologically the mucosa of the guts. The importance of persisting infections in the pharyngeal tonsil (by adenovirus, pneumococcus, H. influenzae) as well as the influence of IgG-mediated immune complex reaction for the perpetuation of inflammatory processes of the middle ear mucosa are discussed. The question to which extent the hyperergic immune reaction is pathogenetically involved in the secretory otitis media is thoroughly discussed. Compared to the other immune mechanisms the hyperergic immune reaction is of minor importance and may be considered as a predisposing factor.
mesh_terms: D000917:Antibody Formation; D000936:Antigen-Antibody Complex / Q000276:immunology; D000956:Antigens, Viral / Q000276:immunology; D002648:Child; D004432:Ear, Middle / Q000276:immunology; D005064:Eustachian Tube / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007073:Immunoglobulin E / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism; D008208:Lymphatic System / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D009092:Mucous Membrane / Q000276:immunology; D010034:Otitis Media with Effusion / Q000276:immunology*; D014066:Palatine Tonsil / Q000276:immunology; D012008:Recurrence
chemical_list: D000936:Antigen-Antibody Complex; D000956:Antigens, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007073:Immunoglobulin E
vernacular_title: Pathogene Immunfaktoren beim rezidivierenden schleimigen Paukenerguss des Kindes.