The aetiology of otitis media with effusion: a review

Otitis media with effusion (OME) is the most common cause of deafness in ch ildren in the developed world. In this article we aim to present an overvie w of current research developments on the aetiology of DME and the resultin g implications for treatment. In the model we describe, the primary event i s inflammation of the middle ear mucosa, usually due to the presence of bac teria. This leads to the release of inflammatory mediators, which cause sec retion of a mucin-rich effusion by up-regulating mucin genes. Prolonged sti mulation of the inflammatory response and poor mucociliary clearance lead t o persistence of the middle ear fluid, giving rise to the clinical presenta tion of OME. We describe OME in the following sequence: the initial product ion of the effusion, the composition of the effusion produced, and factors impairing clearance of the effusion.