Is the healthy middle ear a normally sterile site?
OBJECTIVE
To systematically evaluate the presumption that the healthy middle ear becomes colonized with organisms via the patent eustachian tube using modern microbiologic techniques.


METHODS
Sterile saline washings were obtained from the middle ear of patients in a prospective fashion.


METHODS
Tertiary/quaternary referral centers.


METHODS
Pediatric and adult patients undergoing cochlear implantation surgery.


METHODS
Standard bacterial and viral cultures, and nucleic acid amplification techniques.


METHODS
Identification of organisms.


RESULTS
Specimens were obtained from 13 children and 9 adults. No organisms were identified in any of the specimens, either through standard culture or PCR testing.


CONCLUSIONS
The presumption that the healthy middle ear is colonized by bacteria from the nasopharynx is unsubstantiated.
Westerberg
Brian D
BD
Division of Otolaryngology, Centre for Health Evaluation and Outcome Sciences (CHEOS), St. Paul's Rotary Hearing Clinic, Providence, Vancouver, Canada. BWesterberg@providencehealth.bc.ca
Kozak
Frederick K
FK
Thomas
Eva E
EE
Blondel-Hill
Edith
E
Brunstein
John D
JD
Patrick
David M
DM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003470:Culture Media; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D004432:Ear, Middle / Q000382:microbiology* / Q000821:virology; D005064:Eustachian Tube / Q000276:immunology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology / Q000821:virology; D013506:Otologic Surgical Procedures; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013048:Specimen Handling
D003470:Culture Media; D004269:DNA, Bacterial