Degranulation of mast cells provokes a massive inflammatory reaction in the tympanic membrane

Objective: The pars flaccida is extremely rich in mast cells. On stimulatio n the mast cells release preformed and de novo synthesized inflammatory sub stances. The purpose of this study was to examine how these mast cell subst ances provoke inflammatory changes in the tympanic membrane. Study Design: In vivo, murine model. Methods: In a rat model, the mast cell secretagogue compound 48/80 was applied locally to the tympanic membrane on 4 consecutiv e days and the ensuing inflammatory changes were evaluated by otological, l ight, and electron microscopy 3, 6, 9, 12, 18, 24, 36, and 48 hours and 4, 6, and 8 days later. Results: Degranulation of the mast cells occurred with in 3 hours of applying compound 48/80, Release of the mast cell substances coincided with an inflammatory event characterized by a two-stage reaction: an edema stage,peaking 6 hours after application, followed by a massive in vasion of inflammatory cells, peaking at 24 and 48 hours. Pars flaccida and pars tensa were both involved, pars flaccida showing the earliest changes. Pars tensa exhibited the same biphasic reaction as pars flaccida, but appr oximately 6 hours later. Conclusions: The mast cells of the pars flaccida h ave the capacity to elicit an intense inflammation of the tympanic membrane . The biphasic reaction pattern resembles that observed in experimental oti tis media, suggesting involvement of the mast cells in this inflammatory co ndition of the middle ear.