In such cases, a disease quickly. Inflammatory process lasts without treatment usually a few weeks, but can occur as abortivee form and the transition to chronic infection. The most common chronic otitis arises as a continuation of acute purulent otita which is not cured for a long time. Then acute process goes into podostry and thereafter, and in the chronic phase. Often delayed recovery were so profound pathological changes in the membrane-coated seeds hearing and the walls of middle ear that the full restoration of the structure and functions is not possible. These changes may depend on the virulence and the nature of infection, as well as reducing reactivity organism and lower overall resistance observed in diseases of the blood and exchange with chronic infections, human nutrition, and so on. She stressed the importance of the structure of the mucous membrane middle ear, as well as the risks involved with the last of the temporal bone (the pnevmatization). Hazards on the course otites pathological effects of the upper respiratory tract (adenoids, rinopatii, sinusita, etc.), if the disease is dysfunctions (for example, the nose wheel, yevstahieva pipes, etc.). These adverse conditions on the often occur in children, especially when ekssoudativom diatese, and the chronic seen in childhood. The convergence of several of the above-mentioned factors inflammatory process in the ear can be so weak and unavowed character, which is not observed, even parents. In these cases, do not have to talk about the transition of acute inflammation in chronic, and it should be considered that the inflammation at the onset there is chronic poverty; Such children drum already at the first inspection is a characteristic of chronic inflammation. Sometimes the same chronic evolved gradually as a result of the frequent recurrence of the severe inflammation. Recent may depend on the re-adverse conditions, as well as the high sensitivity of the ear, which remains a post-acute otita. Among chronic purulent inflammation middle ear mezotimpanit occurs in 55% of cases. This is the form of chronic inflammation of middle ear to the process involved in the mucous membrane of middle and lower divisions barrel cavity, as well as the department pipe. Inflammation mucous membrane hearing pipes supported by pathological state of the nasal cavity and chair violates its functions, which in turn leads to a permanent HIV mucous membrane barrel cavity. The most common symptoms mezotimpanita is a permanent central or obodkova perforation, which can be located in different places of the track eardrum, have different size and shape : round, oval, poccoobraznuu. The hole extends almost the entire length of eardrums, leaving only the dunes on the bumper circumference. A large wall visible promontoriuma covered utolschenna congestive mucosa or granulyatsiami. In some cases, the province perforation can be beans with medial wall of a barrel cavity, soedinitionotcanne tiaji contagious and hearing bones, thus violating their mobility.