title: Panel 3: Recent advances in anatomy, pathology, and cell biology in relation to otitis media pathogenesis.
abstract: OBJECTIVE
  The pathogenesis of otitis media (OM) involves a number of factors related to the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx. Although some issues of pathogenesis are fairly well established, others are only marginally indicated by current knowledge, and yet others remain undisclosed. The objective of this article is to provide a state-of-the-art review on recent scientific achievements in the pathogenesis of OM, as related to anatomy, pathology, and cell biology.
  
  
  METHODS
  PubMed, Ovid Medline, and Cochrane Library.
  
  
  METHODS
  Articles published on the pathogenesis of OM and the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx between January 2007 and June 2011 were identified. Among almost 1900 abstracts, the authors selected 130 articles for full article review and inclusion in this report.
  
  
  RESULTS
  New knowledge on a number of issues emerged, including cell-specific expression and function of fluid transportation and innate immune system molecules, mucous cell metaplasia, mucin expression, bacterial adherence, and epithelial internalization, as well as the occurrence, composition, dynamics, and potential role of bacterial biofilm. In addition, the potential role of gastroesophageal reflux disease and cigarette smoke exposure has been explored further.
  
  
  CONCLUSIONS
  Over the past 4 years, considerable scientific progress has been made on the pathogenesis of OM, as related to issues of anatomy, pathology, and cell biology. Based on these new achievements and a sustained lack of essential knowledge, suggestions for future research are outlined.
authors.affiliation: Department of Oto-rhino-laryngology, Head and Neck Surgery, University Hospital of Copenhagen, Copenhagen, Denmark. per.caye.thomasen@regionh.dk
authors.forename: Per
authors.initials: P
authors.lastname: Cayé-Thomasen
authors.forename: Ann
authors.initials: A
authors.lastname: Hermansson
authors.forename: Lauren
authors.initials: L
authors.lastname: Bakaletz
authors.forename: Sten
authors.initials: S
authors.lastname: Hellstrøm
authors.forename: Sho
authors.initials: S
authors.lastname: Kanzaki
authors.forename: Joseph
authors.initials: J
authors.lastname: Kerschner
authors.forename: David
authors.initials: D
authors.lastname: Lim
authors.forename: Jizhen
authors.initials: J
authors.lastname: Lin
authors.forename: Kevin
authors.initials: K
authors.lastname: Mason
authors.forename: Jorge
authors.initials: J
authors.lastname: Spratley
mesh_terms: D004432:Ear, Middle / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology; D005064:Eustachian Tube / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008416:Mastoid / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology; D009305:Nasopharynx / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology; D010033:Otitis Media / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects