“…Previous DNA array screening studies showed cytokine genes are upregulated in the cochleas of BALB/c mice given transtympanic heat-killed bacteria and in cochleas of C3H/HeJ mice with chronic middle ear inflammation (Ghaheri et al, 2007; Ghaheri et al, 2007; MacArthur et al, 2011; Tokarz et al, 2013; MacArthur et al, 2013b). These inflammatory cytokines are predominantly distributed in the cochlear lateral wall as inoculation of middle ears with bacterial components also causes decrease in cochlear blood flow, stria vascularis damage, cytokine expression by spiral ligament fibrocytes, and decreased auditory function (Ichimiya et al, 2003; Sone et al, 2003; MacArthur and Trune, 2006; Moon et al, 2006; Moon et al, 2007; Tsuprun et al, 2008; Woo et al, 2010; Oh et al, 2012). Chronic OM leads to even more significant and permanent inner ear pathology (Cureoglu et al, 2005; MacArthur and Trune, 2006; MacArthur et al, 2008; Joglekar et al, 2010).…”