Otitis media (OM) remains one of the most important and common diseases of childhood. With decreased effectiveness of antimicrobial therapy our laboratory has spent the past 2 decades elucidating the mechanisms surrounding the pathophysiology of OM in hopes of identifying novel methods of intervention. Through this work, substantive advances in the understanding of the pathogenesis, management and treatment of OM continue to develop. This presentation will highlight the most substantive of these developments in the areas of middle ear inflammation, mucin gene expression, biofilm formation and hearing loss associated with OM. It will provide the clinician and researcher with a platform to: 1) facilitate discussion of new concepts with patients and colleagues, 2) allow for incorporation of new modalities into their practice and 3) remain up-to-date regarding clinical and research developments that have the potential to provide new technologies and treatment possibilities.