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Middle ear diseases: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Diseases of the middle ear are among the most complex in etiology and pathogenesis of pathological processes in the ENT organs, primarily due to the fact that the middle ear borders on the posterior and middle cranial fossae and directly communicates with the formations of the inner ear, and through the auditory tube - with the nasopharynx and upper respiratory tract as a whole. According to the figurative definition of B.S. Preobrazhensky, the middle ear is a kind of accessory sinus of the nasopharynx, therefore, all pathological processes occurring in it and the auditory tube invariably affect the condition of the middle ear. Therefore, in inflammatory processes developing in the middle ear, the decisive role belongs to the nasopharynx and the condition of the auditory tube, providing drainage and ventilation functions for the middle ear.
Due to the specified topographic-anatomical position of the middle ear, it can accumulate pathological influences from neighboring anatomical structures (auditory tube, meninges, sigmoid sinus, etc.) and, in turn, be a source of infection spreading to neighboring organs, often causing dangerous complications (sinus thrombosis, meningitis, brain abscess, labyrinthitis, apicitis, etc.).
It should also be noted that the middle ear, being a hollow organ, is sensitive to changes in barometric pressure in the environment.
Its reaction to these changes depends entirely on the physical condition of the auditory tube, and if its functioning is insufficient, the eardrum and the vascular system of the mucous membrane of the tympanic cavity react first, causing the occurrence of so-called baro- or aerotitis.
All inflammatory diseases of the middle ear can be divided into acute and chronic, common and specific, uncomplicated and complicated, tubogenic and hematogenous.
Classification of inflammatory diseases of the middle ear
- Acute catarrh of the middle ear (otitis media catarrhalis acuta)
- Chronic catarrh of the middle ear (otitis media catarrhalis chronica)
- Aerootitis
- Acute inflammation of the middle ear (otitis media acuta):
- non-perforative (catarrhal inflammation stage)
- perforative (stage of purulent inflammation)
- allergic otitis media (otitis media allergies)
- acute otitis media in general infectious diseases
- acute mastoiditis (mastoiditis acuta)
- Acute inflammation of the middle ear in traumatic lesions:
- traumatic otitis and mastoiditis
- contusional otitis and mastoiditis
- otitis and mastoiditis in temporal bone injuries
- Chronic suppurative otitis media (otitis media purulenta chronica):
- mesotympanitis
- epitympanitis:
- uncomplicated
- complicated - granulation, bone caries, cholesteatoma
- Specific inflammations of the middle ear:
- influenza inflammation
- tuberculosis of the middle ear
- syphilis of the middle ear
- "exotic" middle ear diseases
This classification reflects the most common diseases of the middle ear, but it does not exhaust all possible combinations of these diseases and those conditions that are interpreted by clinicians as paradoxical, rarely encountered, especially when a banal infection is combined with a specific one or with certain genetic dysgenesis. The least known and poorly studied in Russia are the so-called exotic diseases (leprosy, yaws, etc.).
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