Insidious Labyrinthine Changes in Otitis Media

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Abstract
For many decades the classical labyrinthine extracranial and intracranial complications of otitis media have been documented, initially by European otologists and then by otologists of other countries including the United States. What has not been fully appreciated or understood is the quiet development of sensori-neural hearing loss which can occur as a concomitant or sequela of otitis media. Out- hypothesis is that in certain patients toxins from otitis media are transported across the round window membrane, leading first to end organ dysfunction of the silent basal turn and ultimately to involvement of lower frequencies readily recognized through audiological testing. The purpose of this paper is to recount past and present studies in our laboratory and others which help explain this phenomenon.