Is the Healthy Middle Ear a Normally Sterile Site?

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