The International Tinnitus Journal

Interrelations Between the Middle and Inner Ear in Otitis Media

This article reviews the importance of the round-window membrane in exposing the labyrinth to or protecting it from the toxic effects of otitis media. Characteristics of the immune system in the human middle ear and middle-ear mechanisms against bacteria are explained. The role of bacteria and bacterial products in inner-ear damage is detailed, and related pathological events are described. The hypothetical role of inflammatory mediators in bacteriainduced inner-ear toxicity is particularly emphasized. Clinical conditions causing these events are detailed, and the most frequently involved microorganisms are mentioned. Finally, roundwindow membrane macroscopic and microscopic anatomy is discussed, and considerations about the exact role of membrane inflammation - protection versus damage of the inner earare expressed.