I'm confused: What is a practical classification for chronic otitis media? What is suppurative and what is nonsuppurative? Where do "atelectatic", "adhesive" types fit in the classification? I've looked into books but I couldn't find a straight forward classification. Thanks for your time...
How to classify otitis media?
- Thread starter drema
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There's lots of overlap and lots of confusion on this subject. Here's the OM gospel according to resxn:
I. OM
A. AOM - purulent active infection of less than 1 month duration
1 - suppurative or non-suppurative
B. Subacute OM - >1 month < 3mos of purulent active infection
1 - suppurative or non-suppurative
C. Chronic OM - > 3 months of purulent active infection (very rare)
1 - suppurative or non-suppurative
2 - most people actually mean OME (otitis media with effusion) when they say Chronic OM
D. OME - non-purulent middle ear effusion present for any length of time
1 - Acute, Subacute, Chronic subtypes based on length of MEE presence
2 - Serous - MEE is serous in nature
3 - Mucoid - MEE is mucoid in nature
Terms like atelectatic or adhesive are descriptors of any of the above, but more commonly apply to mucoid OME. Glue ear is a pseudonym for an atelectatic and/or adhesive OME or Chronic OM when used most correctly, although some people will say glue ear for any mucoid MEE.
Suppurative by definition means "draining" when discussing OM. Suppuration implies a TM which perforated from the OM. However, people will also use suppurative to describe an otorrhea through a pre-existing TM perf or even a tube--this is not entirely correct. The last thing that gets confused is that in other conditions, suppuration simply means purulent. Some docs carry this tradition on incorrectly in the ear and therefore describe a routine AOM without a TM perforation as suppurative.
