Nonsuppurative Otitis Media in Myasthenia Gravis

Case histories of 1,243 patients with myasthenia gravis at Mount Sinai Hospital were reviewed. Of this group, 15 patients had received controlled positive pressure breathing (CPPB) for longer than 96 hours. Eight of the 15 patients developed serous otitis media. The eight case histories are presented, and the pathophysiological effects of CPPB are discussed. An explanation of the effects is based upon the hypothesis that blockage of eustachian tubal lymphatics results in a middle ear transudate consistent with nonsuppurative otitis media.