NFKB1 and otitis media: Several pathologic mechanisms have been proposed for Menière's diseases involving inflammatory pathways including viral-induced inflammation (10), otitis media induced inflammatory products and toxins (41), circulating immune complexes leading to increase cellular permeability (37, 42), genetic predisposition to altered NF-KB mediated inflammatory response (43), distinct and altered cytokine profiles (44), and autoimmunity (37, 45).