The various forms of otitis media depend not only on their varied etiology but also on their management and treatment. They depend also on the systemic condition of the patient as well as on the duration of the disease.
A few cases are the result of direct injury, but the greatest number are the result of a specific infection, and are usually secondary to some nasal or pharyngeal disease, such as catarrh, adenoids or Eustachian tube disease, which is usually secondary to nose or throat disease. Nasal obstruction is an extremely frequent cause of otitis media, because it interferes with the ventilation of the Eustachian tube, and stenosis of the tube means an inability of the middle ear to drain itself. By this means various bacteria, pathogenic and otherwise, gain entrance into the middle ear and set up an inflammation. Chilling of the body and ill advised baths, as
LEACH WJ. ACUTE OTITIS MEDIA.. JAMA. 1907;XLVIII(15):1239–1241. doi:10.1001/jama.1907.25220410015001c