Advances which were achieved in otological diagnosis justify within the framework of processes in the middle ear with a closed long-term exudate to differentiate “otitis media” exudative (serosa, serotympanon), otitis media secretoria (mucotympanon) and otitis media suppu- rativa latens. Each of these units has special features in the etiopathogenesis and prognosis and calls to a great extent also for a different therapeutic procedure. In treatment only treatment of the upper airways is in common, after which serotympanon tends to heal spontaneously. Latent otitis media in the majority requires only paracentesis with suction and aimed antibiotic treatment. Conversely mucotympanon heals only after systematic comprehensive and frequently long-term active surgical and conservative care of the tympanic cavity and auditory tube. The objective of treatment is not merely elimination of hypacusia but also rapid elimination of the pathology is to a great extent incorrect and inadequate treatment of the acute tubal or middle ear inflammation, then inconsistent treatment of these diagnoses becomes the basis of an adhesive process, tympanos- clerosis and finally also cholesteatoma. The key to the development of the above mentioned tubal, tubotympanic processes and their successful treatment is the auditory tube. Drainage of the tympanic cavity is helpful, but not at all the only possible treatment.

        Key words: mucotympanon, serotympanon, otitis media latens, therapy, prognosis, complica-