Middle Ear Infection and Hearing Loss

Abstract

The primary inflammatory disease of the middle ear (ME) is otitis media (OM), a common pediatric infection that accounts for more office visits and surgeries than any other pediatric condition. It also affects adults to a lesser degree. The presence of inflammatory mediators and cells is one of the hallmarks of OM. It is mediated primarily by innate immune receptors, which interact with molecules from the bacteria that cause ME infections without the need for prior sensitization. Chronic and recurrent ME infections in children lead to hearing loss during critical periods of language acquisition and learning, causing delays in reaching developmental milestones and if left untreated, have the potential risks of permanent damage to the middle and inner ear. In this review, we document the presence of inflammation in the ME during OM, discuss current evidence implicating innate immunity in the generation and regulation of ME inflammation, and review the effects of ME inflammation and infection on hearing, auditory processing, the acquisition of language and learning.