title: Is the healthy middle ear a normally sterile site?
abstract: 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.
authors.affiliation: Division of Otolaryngology, Centre for Health Evaluation and Outcome Sciences (CHEOS), St. Paul's Rotary Hearing Clinic, Providence, Vancouver, Canada. BWesterberg@providencehealth.bc.ca
authors.forename: Brian D
authors.initials: BD
authors.lastname: Westerberg
authors.forename: Frederick K
authors.initials: FK
authors.lastname: Kozak
authors.forename: Eva E
authors.initials: EE
authors.lastname: Thomas
authors.forename: Edith
authors.initials: E
authors.lastname: Blondel-Hill
authors.forename: John D
authors.initials: JD
authors.lastname: Brunstein
authors.forename: David M
authors.initials: DM
authors.lastname: Patrick
mesh_terms: 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
chemical_list: D003470:Culture Media; D004269:DNA, Bacterial