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Inflammation of the middle ear structures (otitis media) is usually caused by an extension of infection from the external ear canal or by penetration of the eardrum by a foreign object. Inflammatory polyps are also a common cause of otitis media in cats. The spread of infection through the bloodstream to the middle ear is also possible, but it is rare. Inflammation of the middle ear may lead to inflammation of the inner ear structures (otitis interna). This can in turn lead to loss of balance and deafness. In general, otitis media and interna are more serious than otitis externa, and their effects on the ear may not be reversible.

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