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The middle ear, or space behind the eardrum, should be filled with air. That air comes from the back of the nose up through the eustachian tube. If this tube becomes blocked, fluid can build up in the middle ear. Infection occurs when bacteria or viruses get into the eustachian tube from the back of the nose, causing swelling of the tube, fluid to fill the middle ear space, and infection of the middle ear space.
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