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Structure of the round window membrane.

In the present study the literature on the round window membrane (RWM) structure was reviewed and the rat used as an animal model to elucidate structural alterations of the RWM occurring during serous (SOM) and purulent (POM) otitis media. In SOM the RWM was about the same thickness as that of the control, whereas in POM it increased about 5-fold. The structural changes in POM were mainly confined to the epithelium facing the middle ear cavity. The normal flat epithelium was transformed into a pseudostratified epithelium with both ciliated and goblet cells. Light microscopy revealed only minor changes in the RWM structure during SOM. However, ultrastructurally, the connective tissue layer exhibited dense accumulations of collagen and elastic fibres which were not observed in either normal or the POM ears. The study showed that different inflammatory conditions of the middle ear cause different structural alterations of the RWM. To what extent these changes also influence differently the permeability of the RWM remains to be elucidated. Obviously ultrastructural studies are needed to be able to characterize the structural changes which appear in the RWM in a diseased ear.