Etiologic aspects and pathogenesis of persistent middle ear effusion.

For generations malfunction of the eustachian tube has been considered the primary cause of middle ear disease. Although the role of such malfunction in the initiation of the disorder is well proven, in the light of immunologic research, its contribution to persistence is less certain. Recent developments in immunology and the comparative possible roles of tubal malfunction and an immune complex disorder in persistent middle ear effusion are reviewed with a view to providing an explanation for treatment failures with current therapies.