Understanding the aetiology and resolution of chronic otitis media from animal and human studies

Abstract

Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear) and chronic suppurative otitis media (CSOM). These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, and Eustachian tube function. Chronic otitis media is commonly modelled in mice but most existing models only partially mimic human disease and many are syndromic. Nevertheless, these models have provided insights into potential disease mechanisms, and have implicated altered immune signalling, mucociliary function and Eustachian tube function as potential predisposing mechanisms. Clinical studies of chronic otitis media have yet to implicate a particular molecular pathway or mechanism, and current human genetic studies are underpowered. We also do not fully understand how existing interventions, such as tympanic membrane repair, work, nor how chronic otitis media spontaneously resolves. This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition. It also identifies unanswered questions about its pathogenesis and treatment, with the goal of advancing our understanding of this disease to aid the development of novel therapeutic interventions.

Nasal Delivery of a Commensal Pasteurellaceae Species Inhibits Nontypeable Haemophilus influenzae Colonization and Delays Onset of Otitis Media in Mice

“…Inflammation in the middle ear is a major feature of otitis media (35,36). Our observation that mice pretreated with a single dose of M. muris have lower levels of inflammatory mediators in their upper respiratory tract than mice with no M. muris pretreatment in the otitis media model further demonstrates the potential use of commensal Pasteurellaceae species to prevent NTHi disease.…”

Fungal Osteomyelitis of Temporomandibular Joint and Skull Base Caused by Chronic Otitis Media

“…Chronic otitis media (COM) is a chronic inflammatory disease of the middle ear and mastoid cavity that consists of a set of interrelated clinical phenotypes. The prevalence in adults is rare [1]. In United Kingdom, its prevalence is 1.5% and 2.6% for active and inactive disease respectively [2].…”

Developmental aspects of the tympanic membrane: Shedding light on function and disease

“…Perforations can be related to trauma, in which case they typically heal well, or they can be linked to infection, either acute suppurative otitis media or chronic suppurative otitis media. The latter heals notoriously poorly, even after surgical repair (Bhutta, Thornton, Kirkham, Kerschner, & Cheeseman, ). Until recently, an animal model for studying TM perforation was restricted largely to the Guinea pig, gerbil, and chinchilla, which provide accessible and sizeable TMs (A. Y. Wang et al, ).…”