الفهرس 
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Abstract
This work was designed to study the bacteriological causes of otitis media either acute or chronic or secretory. In this work we have classified our patients into 3 groups:
group I (acute otitis media),
group II (chronic suppurative otitis media),
and group III (otitis media with effusion).
For all patient`s groups, the following parameter were done Careful history taking,Clinical examination, Aspiration of middle ear fluid by tympanocentesis and examination of middle ear fluid according to the following lines Microbiological examination and Immunological examination including Estimation of IL8 in middle ear fluid by ELISA, Total leucocytic count to detect neutrophil count in middle ear fluid andDifferential leucocytic count to detect neutrophil percent in middle ear fluid. from our work, we noticed, In acute otitis media The most common isolated organisms were Haemophilus species (18.8% ), and gb shemolytic Streptococci (18.8% ), and then Strept. pneumoniae (12.5% ), and lastly Staph. aureus (6.3% ), Staph. epidermidis (6.3%) and E. coli (6.3%). And The isolated organisms were most sensitive to amoxicillin plus clavulinic acid (100%), cefotaxime (100%), imipenem (100%), clarithromycin (100%), erythromycin (85.7%), and amoxicillin plus flucloxacillin (81.8%). The mean value of IL8 was 128 (R+ (B18.69 ng/ml .The mean value of neutrophils percent were 75.8% (R+ (B11.52. The mean value of neutrophil count were 26.99 x 10p3 (R+ (B1.7 x 10p3 sIn chronic suppurative otitis media,The most common isolated organisms were Pseudomonas aeruginosa (21.4 %), and then Proteus species (21.4%) as Proteus vulgris (11.9%), Proteus mirabilis (9.5%), and lastly Citrobacter species (14.3%).The isolated organisms were most sensitive to ofloxacin (100%), imipenem (90%), cefopim (87.5%), erythromycin (75%) and ciprofloxacin (72.2%).The mean value of IL8 was 158.36 (R+(B38.52 ng/ml.The mean value of neutrophils percent were 82 .5 %(R+ (B5.13. The mean value of neutrophil count were 40.3 x 10p3 (R+ (B1.9 x 10p3 sIn secretory otitis media. No bacterial growth were detected. The mean value of IL8 was 55.84 (R+ (B10.73 ng/ml .The mean value of neutrophils percent were 57.42% (R+ (B5.06. The mean value of neutrophil count were 3.38 x 10p3 (R+ (B0.5 x 10p3 sThere was a statistically significant difference in IL8 level (ng/ml) among the 3 studied groups compared to each other. Also, there was a statistically significant difference in neutrophils per cent and count among the three studied groups compared to each other.