Middle ear pressure variations during 50% N2O anesthesia as a function of mastoid pneumatization

HYPOTHESIS

Mastoid size is a factor in middle ear (ME) pressure regulation.

BACKGROUND

In a study investigating ME pressure variations during nitrous oxide (N2O) anesthesia, particularly high values of ME pressure increase rate (PIR) were observed in four patients with sclerotic mastoids. The current study is aimed at systematically assessing this observation.

METHODS

Middle ear pressure was measured periodically in 30 patients during 50% N2O anesthesia using tympanometry. For each patient, a curve representing ME pressure during anesthesia was plotted. From the curve steepness, the PIR was calculated. Extent of mastoid pneumatization was assessed planimetrically using mastoid x-rays. Ears then were divided by the median into two groups: ears with small mastoids and ears with large mastoids. The difference between the mean PIR of both ear groups was statistically analyzed.

RESULTS

A significant difference between the PIR was found among the two groups. In ears with mastoids smaller than 9.475 cm2 (the median), the PIR was significantly higher than in ears with mastoids > 9.475 cm2.

CONCLUSIONS

These findings support the concept that the mastoid has a ME pressure buffering capability: the larger its volume, the better its buffering capability. It is therefore suggested, that the mastoid plays a role in ME pressure regulation.

Effects of platelet activating factor on the tubotympanic mucosa and inner ear in the guinea pig

The effect of platelet activating factor (PAF) was studied to elucidate its role in the pathogenesis of otitis media and sensorineural hearing loss. The PAF alone did not induce a reduction of ciliary activity of the cultured middle ear mucosa. However, a dose-dependent decrease in ciliary activity was observed in the presence of the medium containing both PAF and macrophages. Intravenous injection of PAF did not induce dysfunction of the mucociliary system or morphologic changes of epithelium in the tubotympanum, but cytoplasmic vacuolization and ballooning were observed in the inner ear within 1 hour after injection of PAF. In contrast, intratympanic injection of PAF induced mucociliary dysfunction and some pathologic changes in the tubotympanum. Intratympanic inoculation of PAF induced no pathologic findings in the inner ear. These results suggest that PAF is at least partially involved in the pathogenesis of certain middle ear diseases such as otitis media with effusion. Additionally, PAF might be involved in the pathogenesis of some types of unexplained sensorineural hearing loss.

The efficacy of hyaluronic acid foam as a middle ear packing agent in experimental tympanoplasty

The efficacy of hyaluronic acid (HA) foam in the prevention of middle ear adhesions and other structural abnormalities in guinea pigs undergoing experimental tympanoplasty was investigated. Postoperative changes in the middle ear were evaluated by light microscopy after 6 weeks. The presence of adhesions, diminution of airspace, new bone formation, tympanic membrane (TM) formation, and mucosal inflammation was characterized by an objective grading system. Results were compared to absorbable gelatin sponge (AGS) and a control group (no middle ear packing). The control group showed the best average scores for all parameters tested except for adhesion formation. However, these results were statistically significant only when compared with those of the AGS group for airspace preservation, new bone formation, and TM formation. Although the HA foam group showed better average results than did the AGS group for all parameters tested, none were statistically significant. Although HA foam appears to be a promising middle ear packing agent, further experimental trials are warranted before any firm conclusions may be made.

Inhibition of nitric oxide synthase blocks osteoclastic bone resorption in adaptive bone modeling

In this study, the auditory bulla of the gerbil was pressurized, leading to active modeling of the bone of the bulla wall with a significant increase in osteoclast surface and mineral apposition rate. Systemic infusion of L-N(G)-nitro-arginine-methyl ester (L-NAME), an inhibitor of nitric oxide synthase (NOS), inhibited this modeling process. The percentage osteoclast surface (Oc.S/BS) on the inner surface bulla wall was significantly reduced in the L-NAME-treated animals when compared with pressurized saline-treated bullae. Fluorescent bone surface (BSf) mineral apposition rates (MAR) and bone formation rate (BFR) were not significantly different in the pressurized bullae when the L-NAME group was compared with the control (vehicle only) group. However, L-NAME significantly suppressed BSf in the unpressurized bullae. Therefore, it is likely that nitric oxide is a mediator of osteoclastic resorption due to adaptive bone modeling through one or more of the isoforms of NOS.

A2 adenosine receptors in Mongolian gerbil middle ear epithelium and their regulation of Cl- secretion

The present study investigates the effects of adenosine and its analogues on Cl- secretion in primary cultures of gerbil middle ear epithelium. Short-circuit current (Isc), an index of transepithelial active transport, was measured on the same cells cultured on porous filters. Baseline Isc and transepithelial resistance were 27.0 +/- 0.7 microA cm-2 and 275 +/- 7 omega cm2, respectively (n = 178). Extracellular adenosine and its analogues elicited a sustained increase in Isc when added to apical or basolateral surfaces. Both the A2A selective agonist 2-p-(2-carboxyethyl)phenethylamino-5'-N-ethylcarboxamido adenosine and the A2A/A2B nonselective agonist 5'-(N-ethyl-carboxamido)adenosine (NECA) increased Isc, but NECA was more effective than CGS21680. A1 selective antagonist 8-cyclopentyl-1,3-dipropylxanthine did not reduce NECA-induced Isc. These results suggest the presence of both A2A and A2B receptors. NECA did not stimulate a rise in the intracellular Ca2+ concentration ([Ca2+]i) in single middle ear epithelial cells cultured on glass coverslips. Dibutyryl cAMP (dbcAMP) induced an initial transient increase in Isc followed by the sustained plateau. Addition of dbcAMP also caused a transient increase in [Ca2+]i. The protein kinase A inhibitor, N-[2-(p-bromocinnamylamino)ethyl]-5-isoquinolinesulfonamide, greatly reduced the increase in the Isc responses to NECA. 1,2-Bis-(2-aminophenoxy)ethane N,N,N',N'-tetraacetic acid-acetoxymethyl ester influenced neither the NECA-induced increase in Isc nor the dbcAMP-induced sustained phase of Isc, but greatly inhibited the dbcAMP-induced transient increase in Isc. Glibenclamide, a cystic fibrosis transmembrane conductance regulator (CFTR) channel inhibitor, reduced the NECA-induced Isc. These results indicate that extracellular adenosine and its analogues activate the cAMP-protein kinase A system, but not intracellular Ca(2+)-dependent mechanisms, leading to Cl- secretion, possibly through the CFTR Cl- channels in the cultured gerbil middle ear epithelium.

Combined intranasal ipratropium bromide and oxymetazoline in experimental rhinovirus infection

The topical anticholinergic ipratropium bromide and topical decongestant oxymetazoline were tested to determine whether oxymetazoline alone and the combination were well tolerated and reduced rhinorrhea and middle ear pressure abnormalities during experimental rhinovirus infection. The study was double-bind, placebo-controlled, and double dummy in design. Healthy volunteers (n = 109) with low serum neutralizing antibody titer (< or = 1:2) were. Treatments inoculated with rhinovirus (type 39 or Hank's strain) and randomized to treatment with ipra-tropium bromide 0.06% two sprays per nostril (84 micrograms per treatment) and oxymetazoline 0.05% two sprays per nostril, oxymetazoline alone, or placebo. Treatments were self administered twice daily for 5 days beginning 1 day after rhinovirus inoculation. The overall infection rate was 83% and of those infected, 88% felt that they had a cold. During the 3-hour period after dosing, the increase in nasal discharge was significantly lower in the combined ipratropium and oxymetazoline (0.13 +/- 0.17 gm/3 hr, mean +/- SE) than after oxymetazoline alone (0.60 +/- 0.18 gm/3 hr) or vehicle (0.73 +/- 0.18 gm/3 hr). Over the 5-day observation period, total daily nasal discharge also tended to be lower in the ipratropium plus oxymetazoline group (3.67 +/- 0.70 gm/24 hr, mean +/- SE) compared to oxymetazoline (5.61 +/- 0.73: 35% reduction) or the vehicle (5.04 +/- 0.73; 27% reduction) recipients, but the differences were not statistically significant. Subjective assessments of rhinorrhea indicated that the severity of rhinorrhea was significantly better among patients receiving oxymetazoline alone or with ipratropium compared to the vehicle. No significant difference in the cumulative frequencies of middle ear pressure abnormalities (27-31%) were found among the treatment groups. Oxymetazoline does not consistently stimulate or decrease nasal mucus production, and ipratropium added to oxymetazoline is well tolerated and reduces rhinorrhea during experimental rhinovirus infection.

The herbal medicine, sairei-to, enhances the mucociliary activity of the tubotympanum in the healthy guinea pig

Mucociliary dysfunction in the tubotympanum is deeply reflected in the clinical manifestations of otitis media with effusion (OME), and clinical application of pharmacological agents with ciliostimulatory action might therefore enhance the mucociliary clearance function of the tubotympanum to more effectively eliminate middle ear effusions to the pharynx. A herbal medicine, sairei-to, enhances the in vitro ciliary activity of the middle ear during culture. However, this ciliostimulatory effect is not always applicable to the mucociliary system in situ, which may be deteriorated following oral administration of sairei-to. The present study therefore aimed at investigating the in vivo effect of sairei-to on the mucociliary system in the tubotympanum of the guinea pig. Thirty healthy guinea pigs were used. Ten animals were treated with oral administration of physiologic saline solution for 14 successive days. The remaining animals were treated with oral administration of 120 or 600 mg/kg body weight of sairei-to for 14 successive days. Each animal was used for examination of the ciliary activity and mucociliary clearance time of the tubotympanum, 24 h after the final treatment. No significant changes in either ciliary activity or mucociliary clearance time of the tubotympanum were observed upon administration of 120 mg/kg of sairei-to, which was equivalent to the clinical human dosage. By contrast, oral administration of 600 mg/kg of sairei-to significantly enhanced the ciliary activity, but failed to significantly accelerate mucociliary clearance in the tubotympanum, although the mean value of the clearance time became shorter. Therefore, our results suggest that sairei-to to some extent stimulates the function of the mucociliary system. In conclusion, the herbal medicine, sairei-to, might be useful in the treatment of OME, and preventive administration of this drug may be a new therapy in the treatment of recurrent OME.

Eicosanoid synthesis and inactivation in healthy and infected chinchilla middle ears

Otitis media (OM) is an inflammatory reaction of the middle ear (ME) elicited by a variety of stimuli including tubal obstruction, allergy and bacterial infection. The leukotrienes and prostaglandins are among the earliest mediators produced in response to these insults. Their measured levels in human and animal models span a broad range of concentrations. However, their baseline levels and metabolic fates are unknown for the ME. Their dynamics in the ME were examined using the chinchilla animal model, tritiated eicosanoids and a lavage procedure. Prostaglandin levels in the normal ME were 10 times higher than the 34 pg/ear observed for the leukotrienes and thromboxane B2. These levels were significantly increased by the calcium ionophore A23187 and bacterial infection. Leukotrience C4 was the most and prostaglandin E2 the least persistent eicosanoid in the ME. Their residence time in the ME was increased by infection. The rank order of eicosanoid concentrations among comparable studies was surprisingly constant, with prostaglandin E2 the most abundant and the leukotrienes the least. Comparisons of eicosanoid levels from A23187 stimulation and the infectious models sampled at 3 days suggest that the higher levels observed in the infectious models may represent basal eicosanoid production for hyperplastic ME mucosa.

The effects of four, commercial ceruminolytic agents on the middle ear

Four, commercially available ceruminolytic agents and physiological saline were screened for ototoxic and inflammatory reactions on the middle ear mucosae of guinea pigs (n = 38) and dogs (n = 24). Each solution was injected transtympanically in anesthetized animals. The effects were assessed by brain stem auditory evoked response (BAER) tests to evaluate hearing function and by histological examination of the middle ear structures. Varying degrees of hearing loss and inflammation were observed in some guinea pigs and dogs treated with solutions A, C, and D, whereas no abnormal finding was associated with solution B or saline.

Effect of anesthetic agents and middle ear pressure application on distortion product otoacoustic emissions in the gerbil

The functional status of the middle ear system has a crucial importance in the measurements of distortion product otoacoustic emissions (DPOAEs), because each emission signal has to be detected indirectly in the external canal. It was observed that DPOAEs were scarcely detectable in the gerbil anesthetized with pentobarbital. On the other hand, when ketamine was used as an anesthetic, the DPOAE levels were generally high. The differences in the effects of these anesthetic agents on the DPOAEs became less clear when the tympanic bulla was opened. This strongly suggests that the effects might be due to a modification of the middle ear pressure. This study was designed to elucidate the mechanisms of the effects of these anesthetics on the DPOAEs. Comparing the effects of pentobarbital and those of pressure application to the middle ear on the frequency characteristics of DPOAEs, the following conclusions emerged: (1) pentobarbital administration causes negative middle ear pressure in the gerbil; (2) the generated pressure strongly reduces DPOAE conduction through the middle ear; and thus (3) proper selection of anesthetic agents is very important in gerbil experiments that involve OAE measurements.

A totally implantable drug delivery system for local therapy of the middle and inner ear

Local therapy of middle and inner ear diseases is being used, but is restricted to cases of ear drum perforation or to repeated invasive intratympanic drug application by the physician. In accordance with the Medical Device Directive (class III), a bone-anchored, totally implantable drug delivery system (TI-DDS) has been developed. It includes a micropump for subcutaneous, patient-controlled activation, a drug reservoir and a septum port. A thin guide-wired catheter leads from the pump outlet to the point of application in the mastoid or middle ear cavities. Local inner ear therapy with suitable drugs is possible by positioning the catheter's end near the round window membrane. The system requires no battery and will offer a wide range of patient-controlled bolus applications (25 microliters per activation). We first analyzed the three-dimensional implantation geometry of the mastoid cavity. Basic micromechanical problems have been solved in order to create several prototypes. The TI-DDS has already undergone extensive in vitro testing. Recent results of pump rate precision and digital pressure force testing are promising. Local drug treatment for conditions such as lidocaine-sensitive tinnitus, secretory otitis media, Meniere's disease, localized pain and intralesional cancer is under discussion. Furthermore, local application of future biotechnological trophic factors for inner ear treatment is anticipated. The basic engineering is completed and initial animal tests are in preparation.

Middle-ear disease in children exposed prenatally to polychlorinated biphenyls and polychlorinated dibenzofurans

During 1978 and 1979, an episode of poisoning from ingestion of rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans occurred in central Taiwan. We followed-up children who had been born between June 1978 and March 1985, as well as matched unexposed children. The mothers of exposed children had consumed contaminated oils before the children were born. In 1993, otolaryngologists examined the middle ear of each child with a pneumatic otoscope, and they measured the middle-ear pressure by tympanometry with a Rion RS20 impedance audiometer. The exposed children had a significantly higher prevalence of middle-ear diseases than their matched controls. The exposed children who had ear diseases had higher serum levels of 2,3,4,7,8-pentachloro- and 1,2,3,4,7,8-hexachloro-dibenzofurans than the children who did not have similar diseases. Therefore, in this study, children exposed to polychlorinated biphenyls and polychlorinated dibenzofurans had a higher incidence of middle-ear diseases than their controls.

Dexamethasone inhibits mucous glycoprotein secretion via a phospholipase A2-dependent mechanism in cultured chinchilla middle ear epithelial cells

Inhibition or attenuation of mucous hypersecretion in middle ear epithelium is a key step toward resolution of mucoid otitis media. Mucous hypersecretion induced by platelet-activating factor (PAF) in cultured Chinchilla middle ear epithelial cells is dependent on arachidonic acid metabolites via PAF receptors, suggestive of the role of phospholipase A2 (PLA2) in mucous glycoprotein (MGP) secretion. In this study, dexamethasone added to cultured Chinchilla middle ear epithelial cells inhibited baseline and PAF-induced MGP secretion in a concentration-dependent manner. A definite time lag (16 h) was observed between administration of dexamethasone and MGP inhibition. This inhibition was reversed by the addition of exogenous PLA2 (the rate-limiting enzyme of arachidonic acid metabolism) and actinomycin D (an inhibitor of mRNA synthesis). This suggests that dexamethasone inhibits baseline and PAF-induced MGP secretion via a PLA2-dependent mechanism.

Horseradish peroxidase permeation from the capillaries of the stria vascularis after inoculation of endotoxin into the middle ear

Escherichia coli-derived endotoxin was inoculated in the middle ear of guinea pigs 24 hours after being injected intraperitoneally. Twenty-four hours after the middle ear inoculation, horseradish peroxidase (HRP) was injected via the femoral vein and the permeability of HRP through the capillaries of the stria vascularis and the destination of the leaked HRP were examined. A large amount of HRP leaked out of the capillary through he opened endothelial cell junctions and penetrated the enlarged intercellular spaces. Leaked HRP entered the pinocytotic vesicles of the intermediate cells. Even slightly degenerated intermediate cells retained this function. The HRP penetrated the spongelike structure of the marginal cells leading to the intercellular space. This structure was not observed without endotoxin. The HRP could not pass the cochlear duct through the tight junctions between marginal cells. Blood sludging was observed in the strial capillaries. It appeared more frequently in the upper three turns than in the basal turn. The HRP leakage out of the capillaries was observed not only in the upper three turns but also in the basal turn.

Retinoic acid disturbs mouse middle ear development in a stage-dependent fashion

The mammalian middle ear contains a chain of three ossicles, the malleus, incus, and stapes, that transmit into the inner ear the vibrations produced in the tympanic membrane by aerial sound. I show here that retinoic acid interferes with the formation of the middle ear in a stage-specific fashion. The malformations produced are derived from a retinoic acid-induced inhibition of the formation and/or migration of the cranial neural crest that generates the middle ear skeletal elements and not from a respecification of neural crest identity to more posterior fates. I have used these effects of retinoic acid to analyze the temporal sequence of events involved in the morphogenesis of the middle ear. I show that the middle ear bones develop from several primordia that originate in a typical temporal sequence from Day 8 plus 4.5 hr to Day 8 plus 7.5 hr of pregnancy. Moreover, interactions between adjacent bones are not required for their proper formation. My results also suggest a Hoxa-2-mediated patterning of the otic capsule in the region where the oval window is located.

Modulation of middle ear epithelial function by steroids: clinical relevance

The efficacy of steroid therapy for the treatment of otitis media in children remains controversial, and a putative modulation of the middle ear epithelial function has to be demonstrated. Using the MESV cell line, short-circuit current (ISC) technique was used to evaluate changes in ion transport induced by glucocorticoids. Dexamethasone (DXM) produced a dose- and time-dependent increase in ISC in MESV cells. This effect was inhibited by specific glucocorticoid antagonist (RU-38486) and was related to a sodium transport, since the DXM-induced increase in ISC could be prevented or abolished i) by apical addition of the specific Na+ channel inhibitor benzamil; or ii) by substitution of sodium with N-Methyl-glucamine in the incubation medium. RNase protection assay revealed that DXM increased the expression of the alpha subunit sodium channel mRNA, which changes paralleled the modulation of ion transport. These data demonstrate that steroids up-regulate the trans-epithelial sodium transport in the middle ear epithelium. As far as these experimental data can be extrapolated to the in vivo situation, a component of the beneficial effect of steroid therapy for the treatment of otitis media may result from a corticosteroid-induced improvement in fluid clearance from the middle ear.

Middle ear pressure variation: effect of nitrous oxide

Previous studies examining middle ear pressure changes due to inhalant anesthesia, including nitrous oxide, have cited equivocal results. An investigation was performed to closely monitor changes in middle ear pressure during middle ear surgery. Baseline tympanometry was performed before anesthesia, and middle ear pressure was then documented in 1-min time intervals. A total of 97 subjects were studied; 51 received nitrous oxide and halothane, and 46 received halothane alone. Results indicate that nitrous oxide causes significantly greater pressure fluctuations than halothane alone. There were no effects for time of surgery, type of fluid, or baseline. Pressure fluctuation was attributed to eustachian tube function. Case studies are presented to demonstrate subject variability, and suggestions for validation study procedures are presented.

Increase of Cl- secretion induced by Kampo medicine (Japanese herbal medicine), Sai-rei-to, in Mongolian gerbil middle ear epithelium

Sai-rei-to, a type of Kampo medicine (Japanese herbal medicine), has been shown to be clinically effective in treating patients with otitis media with effusion. The effect of Sai-rei-to on the ion transport of the middle ear surface epithelium cultured from the Mongolian gerbil was investigated by using an Ussing chamber. Application of Sai-rei-to to the mucosal bath but not the serosal bath induced an increase in the short-circuit current (I(SC)) in the basal state. The increase in I(SC) was almost completely inhibited by addition of diphenylamine-2-carboxylic acid but not by amiloride, indicating enhancement of Cl- secretion. On the basis of the lack of changes in the intracellular Ca2+ concentration and a sideness of action, the effect of Sai-rei-to on I(SC) is thought to be a direct and selective activation on the apical Cl- channel.

Cell adhesion molecules of experimental otitis media in the rat

We examined the expression of cell adhesion molecules (CAM) in immune-mediated otitis media using keyhole limpet haemocyanin (KLH) in the rat, as well as the regulation of these CAM in peripheral blood polymorphonuclear leucocytes (PMN) and lymphocytes upon exposure to middle ear effusion (MEE). After general immunization, a topical antigen was introduced into the middle ear cavity. One day after exposure, CD18+ cells, primarily PMN, had maximally invaded the middle ear mucosa and mucosal epithelium. Mucosal epithelium strongly expressed intercellular adhesion molecule-1 (ICAM-1), only on the first day. The total number of cells in MEE reached a peak on day 3. On day 3, ICAM-1+ cells had reached a peak of 24.5% of the total cells. On day 2. CD18+ cells had reached a peak at 75.3% of the total cells. We examined the regulation of CAM in peripheral blood upon exposure to MEE. The percentage of fluorescent CD18+ PMN increased with MEE compared to those incubated in its absence, but those of L-selectin-positive PMN significantly decreased CAM on the surface lymphocytes did not change when incubated with MEE. The expression of CAM (CD18, ICAM-1) appears important for the initiation of otitis media. Moreover, it was thought that the interaction between the infiltrated PMN and MEE may modify the expression of CAM during the inflammatory process in the middle ear cavity.

Effect of lipoxygenase inhibition on mucous glycoprotein secretion from chinchilla middle ear epithelial cells in vitro

Lipoxygenase is an enzyme that metabolizes arachidonic acid down to leukotrienes. Recent studies have shown that the enzyme is implicated in mucous glycoprotein (MGP) secretion stimulated by inflammatory mediators in the airways, suggesting its possible role in secretion of MGP from middle ear epithelial cells. To investigate a correlation between MGP secretion and the arachidonic acid metabolites, we examined the effects of nordihydroguaretic acid (NDGA, both a cyclooxygenase and lipoxygenase inhibitor), low-dose indomethacin (an inhibitor of cyclooxygenase), and A63162 (an inhibitor of lipoxygenase) on MGP secretion in cultured chinchilla middle ear epithelial cells. It was found that lipoxygenase inhibition led to reduction of MGP secretion from cultured chinchilla middle ear epithelial cells, while cyclooxygenase inhibition did not. Both cyclooxygenase and lipoxygenase inhibition resulted in profound blockage of MGP secretion in baseline and platelet activating factor-stimulated MGP secretion. It was concluded, therefore, that MGP secretion was linked to arachidonic acid metabolites, especially lipoxygenase products.

Growth factors during endotoxin-induced otitis media

The presence of growth factors in the middle ear fluid was examined during lipopolysaccharide-induced otitis media (OM) in the chinchilla. There was a progressive significant increase in the proliferative activity detected in the LPS-free MEF by five days in culture. We conclude that lps indirectly mediates hyperproliferative changes in the middle ear during OM by inducing growth factors.

Lysates from cultured allogeneic keratinocytes stimulate wound healing after tympanoplasty

In the past, cultured keratinocyte allografts have been used with benefit in the treatment of burn wounds and leg ulcers. Since in burn wounds autologous and allogeneic fresh keratinocyte cultures were found to give similar favorable results as lysates of allogeneic cultured cells, the authors investigated whether this lysate mixed in an antibiotic suspension would also accelerate the epithelial healing after routine tympanoplasty. In a double blind setting the healing process in 50 consecutive tympanoplasty ears was studied: an acceleration of healing of 8 days was observed in the lysate-treated group (39.25 days) as compared with the control group (47.23 days). The percentage of ears which healed within 6 weeks (after 5 weekly applications of 200 microliters suspension in both groups) was significantly higher in the treated group (61%) than in the control population (36%). Although the therapeutical effect of the keratinocyte lysate in this study is believed to be due primarily to its mitogenic activity through growth factors or cytokines, at present it is still unclear which growth factors are involved and which combinations of these factors have to be present to modulate the different stages of the complex healing processes.

Effect of SC-41930, a potent selective leukotriene B4 receptor antagonist, in the guinea pig model of middle ear inflammation

Arachidonic acid metabolites such as prostaglandins and leukotrienes have been shown to play an important role in the pathogenesis of otitis media (OM). Among these mediators, leukotriene B4 (LTB4) is one of the most potent inducers of inflammatory processes. SC-41930 has been shown to be a specific LTB4 receptor antagonist both in vitro and in vivo. In this study, anti-inflammatory effects of SC-41930 were investigated in a guinea pig model of OM induced by middle ear (ME) inoculation of killed Staphylococcus aureus. Outcome of treatment was determined by measurement of myeloperoxidase activity in the samples of ME mucosa, evaluation of temporal bone histopathology, and presence of ME fluids. Myeloperoxidase activity in the SC-41930-treated group was found to be significantly lower than that in the control group. Histopathology of temporal bones indicated decreased inflammation in the treated group as compared to the controls. In addition, ME fluids were absent in four out of six treated animals. These results demonstrate that SC-41930 can produce significant anti-inflammatory effects in this model of OM.