Permeability of the middle ear to staphylococcal pyrogenic exotoxin in otitis media.

Middle ear permeability after instillation of staphylococcal pyrogenic exotoxin was studied in each of 12 cats, 6 of them with otitis media induced by obstructing their eustachian tubes. This is the first report that there is passage of toxin to the perilymph, cerebrospinal fluid and blood not only in diseased ears, but also in normal controls, 25 min and 12 h after exposure of the middle ear cavity and round window membrane to toxin. The data suggest a pathophysiological explanation for the association of otitis media and sensorineural hearing loss and/or endolymphatic hydrops; potentially both entities can be caused by exotoxins. It also documents the extraordinary capabilities of movement of staphylococcal exotoxin.