Objective: To systematically evaluate the presumption that the healthy middle ear becomes colonized with organisms via the patent eustachian tube using modern microbiologic techniques.
Study design: Sterile saline washings were obtained from the middle ear of patients in a prospective fashion.
Setting: Tertiary/quaternary referral centers.
Patients: Pediatric and adult patients undergoing cochlear implantation surgery.
Intervention(s): Standard bacterial and viral cultures, and nucleic acid amplification techniques.
Main outcome measure(s): 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.
Conclusion: The presumption that the healthy middle ear is colonized by bacteria from the nasopharynx is unsubstantiated.