title: Interrelations between the middle and inner ear in otitis media.
abstract: This article reviews the importance of the round-window membrane in exposing the labyrinth to or protecting it from the toxic effects of otitis media. Characteristics of the immune system in the human middle ear and middle-ear mechanisms against bacteria are explained. The role of bacteria and bacterial products in inner-ear damage is detailed, and related pathological events are described. The hypothetical role of inflammatory mediators in bacteria-induced inner-ear toxicity is particularly emphasized. Clinical conditions causing these events are detailed, and the most frequently involved microorganisms are mentioned. Finally, round-window membrane macroscopic and microscopic anatomy is discussed, and considerations about the exact role of membrane inflammation--protection versus damage of the inner ear--are expressed.
authors.affiliation: Department of Otolaryngology, New University of Lisbon, Lisbon, Portugal. np46ab@mail.telepac.pt
authors.forename: Rui
authors.initials: R
authors.lastname: Penha
authors.forename: Pedro
authors.initials: P
authors.lastname: Escada
mesh_terms: D001427:Bacterial Toxins / Q000633:toxicity*; D007758:Ear, Inner / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D004432:Ear, Middle / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D010033:Otitis Media / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D010539:Permeability; D012405:Round Window, Ear / Q000276:immunology / Q000382:microbiology* / Q000473:pathology
chemical_list: D001427:Bacterial Toxins