Role of innate immunity in the pathogenesis of otitis media

Otitis media (OM) is one of the most frequent diseases afflicting humans and is prevalent in both developed and developing countries. It represents a significant healthcare burden, with over 5 billion dollars spent every year in the world on this disease. The term 'otitis media' covers a wide spectrum of disease, and is used to describe illnesses with predominantly middle ear symptoms. With its diverse clinical syndromes and affected host groups, OM remains one of the challenging diseases encountered in clinical practice. 5] This can cause serious deterioration in the quality of life. 8 Studies show that 80% of children will have experienced at least one episode of OM by their third birthday and 40% will have six or more recurrences by the age of 7 years. 9 OM is also the predominant reason for antibiotic prescription. 10 It is the primary indication for tympanostomy tube insertion, which is the most commonly performed operation on children. he pathogenesis of OM is thought to be multifactorial and includes Eustachian tube dysfunction, allergy, viral and bacterial invasion, reduced ciliary function of both the middle ear and Eustachian tube mucosa, smoke exposure, gastro-esophageal reflux, and autoimmune and many other etiologies not yet fully understood. 12 OM can lead to life-threatening extracranial and intracranial complications. Every year 28,000 deaths are attributable to OM complications, mainly through meningitis and brain abscess. here are two main entities of OM: acute otitis media (AOM) and chronic suppurative otitis media (CSOM). AOM is defined as the presence of inflammation in the middle ear accompanied by the rapid onset of signs and symptoms of an ear infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common causative agents of AOM.