We conducted a comparison study to determine if the development of otitis media in adults is correlated with craniofacial morphology. Our study population was made up of 66 adults, aged 18 to 40 years; 32 of these patients had otitis media and 34 did not. All subjects underwent a complete otolaryngologic examination, video-otoscopy, fiberoptic nasal endoscopy, and lateral cephalometry. Statistical analysis of the cephalometric measurements in the otitis media group and the control group revealed significant differences in the angle between the anterior skull base and medial skull base, upper facial height, and anterior facial height. Also, some significant differences were seen between the measurements in the otitis media group and the normal dimensions of the harmonic face as reported in the literature; these differences were seen in the length of the anterior skull base, the angle of cranial deflection, the depth of the maxilla, the angle of the mandibular plane, the angle of facial depth, the angle of the facial cone, and lower facial height. Not all of these significant differences, however, were predictive of the evolution of otitis media. Based on our analysis, we conclude that four cephalometric measurements are predictive of the evolution of otitis media: (1) the length of the anterior skull base, (2) the angle between the anterior skull base and medial skull base, (3) maxillary depth, and (4) upper facial height. No correlations were found between otitis media and nasal blockage or between otitis media and facial type.