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  Indian J Med Microbiol
 

Figure 1: A model depicting anatomical route for transmucosal spread of SARS-CoV-2 from the nasopharynx to the middle ear and mastoid cavities. [There is an anatomical continuity from the nasopharynx to the middle ear and then to the mastoid through the Eustachian tube. This route is initially lined by the mucosal respiratory (nasopharynx to the Eustachian tube) epithelium and then secretory simple squamous (middle ear and mastoid) epithelium which express angiotensin-converting enzyme 2 receptors that can bind SARS-CoV-2, hence presents a transmucosal route of spread for entry of the virus while inhaling air through the nose].

Figure 1: A model depicting anatomical route for transmucosal spread of SARS-CoV-2 from the nasopharynx to the middle ear and mastoid cavities. [There is an anatomical continuity from the nasopharynx to the middle ear and then to the mastoid through the Eustachian tube. This route is initially lined by the mucosal respiratory (nasopharynx to the Eustachian tube) epithelium and then secretory simple squamous (middle ear and mastoid) epithelium which express angiotensin-converting enzyme 2 receptors that can bind SARS-CoV-2, hence presents a transmucosal route of spread for entry of the virus while inhaling air through the nose].