Examination of disease patterns in the past has often been difficult due to lack of morphological evidence. This study presents a new unbiased method for estimation of occurrence of infectious middle ear disease (IMED) in childhood. The method is based on the relation between IMED in childhood and small or asymmetric pneumatized cell areas in the temporal bones as seen on standardised X-rays. A polychotomous logistic regression model was applied on 434 pneumatized cell areas in temporal bones from 34 adult living Greenlandic Inuit, 56 adult crania from the 18th to the 19th century, A.D. and 127 adult Inuit crania from the pre-European colonization period (before A.D. 1721) of Greenland. The occurrence of IMED as designated by the model was eight out of 34 (23.5 per cent) in living Inuit, 10 out of 56 (17.9 per cent) in crania from the 18th to 19th century and six out of 127 (4.7 per cent) in crania from the pre-colonization period. These frequencies differed significantly (p < 0.002). The mean area size also differed significantly, thus indicating a change in occurrence of IMED and a decrease in area sizes from past to present in Greenland.