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Contents
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xi
62 Local Management of the Mastoidectomy Cavity . . . . . . . . . . . . . . . . . . . . . . . . . . 691
Leandro Rodríguez, Raimundo José García-Matte, and Marcos V. Goycoolea
63 Reconstruction and Obliteration of the Mastoid Cavity . . . . . . . . . . . . . . . . . . . . . 695
Michael B. Gluth and Ryan T. Judd
64 Subtotal Petrosectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 707
Gianluca Piras, Wenlong Tang, Antonio Caruso, Lorenzo Lauda,
Abdelkader Taibah, and Mario Sanna
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 717

Contributors
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José Vicente Boleli Scardini Alves Department of Otolaryngology, Banco de Olhos de
Sorocaba Hospital, Sorocaba, Brazil
JoséAlzerreca Department of Otolaryngology, Clínica Universidad de Los Andes, Santiago,
Chile
AneesaAnsar Department of Otolaryngology, Tarabichi Stammberger Ear and Sinus Institute,
Dubai, UAE
BernardArs University of Namur, Namur, Belgium
Temporal Bone Foundation, Brussels, Belgium
Douglas Backous Department of Neurotology, Proliance Surgeons, Puget Sound ENT,
Edmonds, WA, USA
Margherita Basso Department of Otolaryngology-Head and Neck Surgery, University
Hospital of Modena, Modena, Italy
JeffersonAndréBauer Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
Hospital Mãe de Deus, Porto Alegre, Brazil
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
PierfrancescoBettini ENT & Audiology Department, University Hospital of Ferrara, Ferrara,
Italy
DianeBiju Holy Spirit Hospital, Mumbai, India
NicolaBisi Department of Otolaryngology-Head and Neck Surgery, University Hospital of
Modena, Modena, Italy
CharlotteM.Burford East Kent Hospitals University NHS Foundation Trust, Ashford, Kent,
UK
ByankaCagnacciBuzo Santa Casa de Sao Paulo School of Medical Science Hearing and
Speech Science Program, São Paulo, Brazil
Department of Research, Cochlear LATAM, Panamá City, Panamá
Inesangela Canali Department of Otolaryngology, Pontical Catholic University, Porto
Alegre, Rio Grande do Sul, Brazil
Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
VlademirCantarelli Department of Basic Health Sciences, Universidade Federal de Ciencias
da Saude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
JorgeCaro Ponticia Universidad Católica de Chile, Santiago, Chile
AntonioCaruso Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
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Daniela Carvalho Division of Otolaryngology Head and Neck Surgery, University of
California, San Diego, La Jolla, CA, USA
Rady Children’s Hospital, San Diego, San Diego, CA, USA
LeandroGuenade Castro Department of Otolaryngology, Head & Neck Surgery, Banco de
Olhos de Sorocaba Hospital, Sorocaba, SP, Brazil
MarioCastro Chilean National Museum of Natural History, Santiago, Chile
Department of Morphology, Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo,
Santiago, Chile
S.CatherineCatenacci Department of Otolaryngology, Clinica Universidad de Los Andes,
Santiago, Chile
FranciscoChiang Department of Radiology, Clínica Universidad de Los Andes, Santiago,
Chile
AnaPaulaChornobay Hospital Universitário Cajuru, Curitiba, PR, Brazil
Sara Concha Department of Pediatric Immunology and Infectious Diseases, Ponticia
Universidad Católica de Chile, Santiago, Chile
Molly Cooper Department of Surgery/Otolaryngology, UCSD School of Medicine, San
Diego, CA, USA
HannahL.Cornwall Department of Paediatrics, Ysbyty Gwynedd, Bangor, Wales, UK
Contributors
SadySelaimenda Costa Department of Otolaryngology, Head and Neck Surgery, School of
Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
School of Medicine - Federal University of Rio Grande do Sul, Porto Alegre, Brazil
Otology and Neurotology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio
Grande do Sul, Brazil
Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
International Hearing Foundation, Minneapolis, MN, USA
American Academy of Otolaryngology and Head & Neck Surgery, Alexandria, VA, USA
Department of Otolaryngology, University of Minnesota, Otopathology Laboratory,
Minneapolis, MN, USA
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
Otology and Neurotology Division, Sistema Hospitalar Mãe de Deus, Porto Alegre, Brazil
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
Felipeda Costa Huve Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
Hospital Mãe de Deus, Porto Alegre, Brazil
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
Rafaelda CostaMonsanto Department of Otolaryngology, Head & Neck Surgery, University
of Minnesota, Minneapolis, MN, USA
Department of Otolaryngology, Head and Neck Surgery, Universidade Federal de São Paulo/
Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
Department of Otolaryngology, Head & Neck Surgery, Banco de Olhos de Sorocaba Hospital,
Sorocaba, SP, Brazil

Contributors
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xv
SebahattinCureoglu Otopathology Laboratory, Department of Otolaryngology, University
of Minnesota Physicians (UMP), University of Minnesota, Minneapolis, MN, USA
MarcelaLehmkuhlDamiani Hospital de Clínicas de Porto Alegre, Universidade Federal do
Rio Grande do Sul, Porto Alegre, Brazil
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
RolandDouglasEavey Department of Otolaryngology-Head and Neck Surgery, Vanderbilt
University Medical Center, Nashville, TN, USA
CarolineCatherineLacerdaElias Federal University of Rio Grande do Sul, Porto Alegre,
Rio Grande do Sul, Brazil
Department of Otolaryngology, Hospital Nossa Senhora da Conceição, de Porto Alegre (GHC),
Porto Alegre, Rio Grande do Sul, Brazil
Pilar Epprecht Department of Otolaryngology, Clínica Universidad de Los Andes and
Exequiel González Cortés Hospital, Santiago, Chile
Department of Otolaryngology, Exequiel González Cortés Hospital, Santiago, Chile
DominiqueEstève Chemin de Sainte-Roustagne, Manosque, France
MatthewR.B.Farr Doncaster Royal Inrmary, Doncaster, UK
FranciscoTocornal J. Department of Otolaryngology, Clínica Universidad de Los Andes,
Santiago, Chile
RaimundoJosé García-Matte Department of Otolaryngology, Clínica Universidad de Los
Andes, and Hospital de la Florida, Santiago, Chile
MichaelB.Gluth University of Chicago Section of Otolaryngology-Head and Neck Surgery,
Chicago, IL, USA
AditiGovil Lilavati Hospital and Research Centre, Mumbai, India
BJ Medical College, Ahmedabad, India
MarcosV.Goycoolea Department of Otolaryngology, Clínica Universidad de Los Andes,
Santiago, Chile
KanchanGupta Lilavati Hospital and Research Centre, Mumbai, India
CatalinaGutiérrez Hospital Sótero del Río, Santiago, Chile
AnnHermansson Department of ENT, Lund University Hospital, Lund, Sweden
MaríaJoséHerrera J Department of Otolaryngology, Clínica Universidad de Los Andes,
Santiago, Chile
RodrigoHoyos-Bachiloglu Department of Pediatric Immunology and Infectious Diseases,
Ponticia Universidad Católica de Chile, Santiago, Chile
FernandaRochaHueb University of Uberaba, Uberaba, Minas Gerais, Brazil
MarcelaRochaHueb University Unilago, São Paulo, Brazil
MarceloMiguelHueb University of São Paulo, São Paulo, Brazil
ENT Discipline and ENT Service, Federal University of Triângulo Mineiro, Uberaba, Brazil
Hospital Santa Lúcia of Uberaba, Uberaba, Minas Gerais, Brazil
Ryan T.Judd University of Chicago Section of Otolaryngology-Head and Neck Surgery,
Chicago, IL, USA

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Timothy T. K. Jung Department of Otolaryngology-Head & Neck Surgery, Loma Linda
University School of Medicine, Jerry L.Pettis Veterans Medical Center, Loma Linda, CA,
USA
Inland Ear Head & Neck Clinic, Riverside, CA, USA
JoséCarlosConventoJúnior Department of Otolaryngology, Head & Neck Surgery, Banco
de Olhos de Sorocaba Hospital, Sorocaba, SP, Brazil
Mustafa Kapadia Department of Otolaryngology, Tarabichi Stammberger Ear and Sinus
Institute, Dubai, UAE
AdamC.Kaufman Otorhinolaryngology– Head & Neck Surgery, University of Maryland,
Baltimore, Baltimore, MD, USA
Cemil Kayaalp Otopathology Laboratory, Department of Otolaryngology, University of
Minnesota, Minneapolis, MN, USA
SuanurM.Kayaalp Otopathology Laboratory, Department of Otolaryngology, University of
Minnesota Physicians (UMP), University of Minnesota, Minneapolis, MN, USA
Arwa Kurabi Department of Surgery/Otolaryngology, UCSD School of Medicine, San
Diego, CA, USA
LorenzoLauda Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
JoelLavinsky Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
Santa Casa de Porto Alegre, Porto Alegre, Brazil
Contributors
LuizLavinsky Federal University of Rio Grande do Sul, School of Medicine, Porto Alegre,
Brazil
Sul-Rio-Grandense Academy of Medicine, Porto Alegre, Brazil
NamK.Lee Department of Otolaryngology-Head and Neck Surgery, School of Medicine,
University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Jai-senF.Leung Ponticia Universidad Católica de Chile, Santiago, Chile
JoãoPedroNevesLubianca Federal University of Rio Grande do Sul, Hospital de Clínicas
de Porto Alegre, Porto Alegre, RS, Brazil
MarceloNevesLubianca Pontical Catholic University of Rio Grande do Sul, São Lucas
Hospital, Porto Alegre, RS, Brazil
Rochane Figini Maciel Chronic Otitis Media Study Group, School of Medicine, Federal
University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
Daniele Marchioni Department of Otolaryngology-Head and Neck Surgery, University
Hospital of Modena, Modena, Italy
MatthewJ.Mason Department of Physiology, Development & Neuroscience, University of
Cambridge, Cambridge, UK
RafaelC.Monsanto Otopathology Laboratory, Department of Otolaryngology, University of
Minnesota, Minnesota, MN, USA
Department of Otolaryngology, Head & Neck Surgery, University of Minnesota, Minnesota,
MN, USA
TiagoIsamuSaiguchiMurakami Pontifícia Universidade Católica do Rio Grande do Sul,
Porto Alegre, Brazil

Contributors
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xvii
JoséFaibesLubianca Neto Graduate Program of Pediatrics of Federal University of Health
Sciences of Porto Alegre, Porto Alegre, RS, Brazil
Otorhinolaryngology Service at Santa Casa de Misericórdia de Porto Alegre Hospital, Porto
Alegre, RS, Brazil
Pediatric Otorhinolaryngology Service at Santo Antonio Children’s Hospital, Porto Alegre,
RS, Brazil
CarrieL.Nieman Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
WiquinylsonFrançade Oliveira Universidade Federal do Rio Grande do Sul, Porto Alegre,
Brazil
Norma de Oliveira Penido Department of Otolaryngology, Head and Neck Surgery,
Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo,
Brazil
LetíciaA.Oyama Hospital Universitário Cajuru, Curitiba, PR, Brazil
MichaelM.Paparella Department of Otolaryngology, University of Minnesota and Paparella
Clinic, Minneapolis, MN, USA
Otopathology Laboratory, Department of Otolaryngology, University of Minnesota and
Paparella Clinic, Minneapolis, MN, USA
American Academy of Otolaryngology and Head & Neck Surgery, Alexandria, VA, USA
Department of Otolaryngology, Head & Neck Surgery, University of Minnesota, Minnesota,
MN, USA
JavieraPardo Otolaryngologist Department of Otolaryngology, Clínica Universidad de Los
Andes, Santiago, Chile
AishanPatil Vascular Surgery, Borders General Hospital, Melrose, Scotland, UK
HenriqueFurlanPauna Hospital Universitário Cajuru, Curitiba, PR, Brazil
Hospital IPO, Curitiba, Paraná, Brazil
Department of Otolaryngology, Hospital Universitario Cajuru, Curitiba, Paraná, Brazil
DeniseRottaRuttkayPereira Department of Otolaryngology and Head and Neck Surgery,
Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS),
Porto Alegre, RS, Brazil
Manuel Ruttkay Pereira Department of Pediatrics, School of Medicine, Ponticia
Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul
(UFRGS), Porto Alegre, RS, Brazil
MariaBeatrizRottaPereira Department of Otolaryngology and Head and Neck Surgery,
Hospital Sao Lucas, Ponticia Universidade Católica do Rio Grande do Sul (PUCRS), Porto
Alegre, RS, Brazil
GianlucaPiras Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
Dennis S. Poe Department of Otolaryngology-Head and Neck Surgery, Boston Children’s
Hospital, Boston, MA, USA
BereniceDiasRamos Phoniatrics, Department of Ophthalmology and Otorhinolaryngology,
Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
Otorhinolaryngology & Head and Neck Surgery Service, Hospital de Clínicas de Porto Alegre,
Porto Alegre, RS, Brazil
Phoniatrics, DERDIC—PUCSP, São Paulo, SP, Brazil

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PhoebeH.Ramos Ponticia Universidad Católica de Chile, Santiago, Chile
G.RaquelLevy Department of Otolaryngology, Clinica Universidad de Los Andes, Santiago,
Chile
DouglasK.Reinhardt Hospital São Lucas da PUCRS, Porto Alegre, Brazil
LeandroRodríguez Department of Otolaryngology, Clínica Universidad de Los Andes, and
Hospital del Salvador, Santiago, Chile
LetíciaPetersenSchmidtRosito School of Medicine - Federal Universityof Rio Grande do
Sul, Porto Alegre, Brazil
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
International Hearing Foundation, Minneapolis, MN, USA
Department of Otolaryngology—Head and Neck Surgery, Porto Alegre Clinica’s Hospital,
Porto Alegre, Rio Grande do Sul, Brazil
AlessiaRubini Department of Otolaryngology-Head and Neck Surgery, University Hospital
of Modena, Modena, Italy
Allen F. Ryan Department of Surgery/Otolaryngology, UCSD School of Medicine, San
Diego, CA, USA
Department of Neurosciences, UCSD School of Medicine, San Diego, CA, USA
San Diego VA Healthcare System, La Jolla, CA, USA
Contributors
MatheusSaito Department of Otolaryngology, Head & Neck Surgery, Banco de Olhos de
Sorocaba Hospital, Sorocaba, SP, Brazil
Hamed Sajjadi Stanford University, School of Medicine, San Jose Ear & Sinus Medical
Center, Los Gatos, CA, USA
Karina Salvi Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital,
Sorocaba, SP, Brazil
MarioSanna Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
PeterL.SantaMaria Otolaryngology, Head & Neck Surgery, Stanford University, Stanford,
CA, USA
ClaudiaM.Santoni School of Clinical Medicine, University of Cambridge, Cambridge, UK
RegieLynP.Santos-Cortez Department of Otolaryngology-Head and Neck Surgery, School
of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Livia Tamie T. Sassaki Department of Otolaryngology, Banco de Olhos de Sorocaba
Hospital, Sorocaba, SP, Brazil
M. Schürmann Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum
Bielefeld, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
FabioAndreSelaimen Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
FábioAndréSelaimen Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
Emily Sereno Department of Surgery/Otolaryngology, UCSD School of Medicine, San
Diego, CA, USA
ShailaSidam All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Contributors
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AliceLangSilva Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
Mauricio Noschang Lopes da Silva Hospital de Clínicas de Porto Alegre, Porto Alegre,
Brazil
Instituto Gaúcho de Otorrinolaringologia, Porto Alegre, Brazil
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto
Alegre, Brazil
Otology and Neurotology Division, Sistema Hospitalar Mãe de Deus, Porto Alegre, Brazil
Service of Otolaryngology, Head & Neck Surgery, Hospital de Clínicas de Porto Alegre, Porto
Alegre, Brazil
VagnerAntonioRodriguesda Silva State University of Campinas (Unicamp), Campinas,
Brazil
Faculty of Medical Sciences—UNICAMP, Campinas, Brazil
Chrisde Souza Lilavati Hospital, Mumbai, India
Holy Family Hospital, Mumbai, India
Otolaryngology—Head and Neck Surgery, SUNY Brooklyn, New York, NY, USA
Otolaryngology—Head and Neck Surgery, LUSHSC, Shreveport, LA, USA
Faculty SUNY, Brooklyn, NY, USA
LSUHSC, Shreveport, LA, USA
Lilavati Hospital, Holy Family Hospital, Holy Spirit Hospital, Mumbai, India
Rosemarie de Souza Internal Medicine, BYL Nair Hospital and TNM College, Mumbai,
India
Joshua A. Stramielo Division of Otolaryngology Head and Neck Surgery, University of
California, San Diego, La Jolla, CA, USA
H.Sudhoff Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Bielefeld,
Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
AbdelkaderTaibah Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
AlexJoseph Fejta Tampio Department of Neurotology, Proliance Surgeons, Puget Sound
ENT, Edmonds, WA, USA
WenlongTang Gruppo Otologico and Mario Sanna Foundation, Piacenza-Rome, Italy
Muaaz Tarabichi Department of Otolaryngology, Tarabichi Stammberger Ear and Sinus
Institute, Dubai, UAE
VishalTyagi Holy Family Hospital, Holy Spirit Hospital, Mumbai, India
Department of ENT, VN Desai Hospital, Mumbai, India
Bryan K. Ward Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
StephanieJ.Wong Pediatric Otolaryngology, Mount Sinai, NY, USA

Definitions, Terminology,
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andClassification
MarcosV.Goycoolea, SadySelaimenda Costa,
Chrisde Souza, andMichaelM.Paparella
1
Otitis media (OM) is a multifactorial, multifaceted disease
that manifests as an inammatory process in the middle ear,
mastoid, and Eustachian tube. It is the result of prevailing
aggression against the body’s immunological defense system, the degree of which depends on the interactions between
the two opposing forces (aggressive and defensive). It is a
dynamic disease, often used to describe a continuum of
related diseases [1], in which some forms lead to others
(Figs.1.1 and 1.2), resulting at times in complications and
M. V. Goycoolea (*)
Department of Otolaryngology, Clínica Universidad de Los Andes,
Santiago, Chile
S. S. da Costa
Department of Otolaryngology, Head and Neck Surgery, School of
Medicine, Federal University of Rio Grande do Sul,
Porto Alegre, Rio Grande do Sul, Brazil
Otology and Neurotology Division, Hospital de Clínicas de Porto
Alegre, Porto Alegre, Rio Grande do Sul, Brazil
C. de Souza
Lilavati Hospital, Mumbai, India
Holy Family Hospital, Mumbai, India
Otolaryngology—Head and Neck Surgery, SUNY Brooklyn,
New York, NY, USA
Otolaryngology—Head and Neck Surgery, LUSHSC,
Shreveport, LA, USA
M. M. Paparella
Department of Otolaryngology, University of Minnesota and
Paparella Clinic, Minneapolis, MN, USA
e-mail: papar001@umn.edu
sequelae (Table1.1). In addition to local factors, this process
is directly inuenced not only by the neighboring anatomical
structures but also by the host’s relationship with the
environment.
The term “otitis media (OM)” itself describes an inammation of the middle ear and includes not only the middle ear
cavity but also the Eustachian tube and the mastoid.
This disease can be classied on a clinical or histopathological basis [3].
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023
M. V. Goycoolea et al. (eds.), Textbook of Otitis Media, https://doi.org/10.1007/978-3-031-40949-3_1
1

2
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Fig. 1.1 The continuum of
otitis media (Copyright
Marcos Y.Goycoolea 2023;
all rights reserved)
Fig. 1.2 Classication and continuum of otitis media. (Copyright
Marcos Y.Goycoolea 2023; all rights reserved). Classication and continuum of otitis media with effusion (OME). POM purulent otitis
media, SOM serous otitis media, MOM mucoid otitis media, COM
chronic otitis media, OM otitis media
Table 1.1
and Jung 1991 [2])
Complications
Temporal bone Extratemporal
Middle ear Intracranial
Facial nerve paralysis Extradural abscess
Ossicular lesions Subdural abscess
Perforations of the TM
Mastoid Lateral sinus
Reduced pneumatization Otitis hydrocephalus
Coalescent mastoiditis
Complications and sequelae of otitis media (from Goycoolea
a
Brain abscess
Meningitis
thrombophlebitis
Extracranial
M. V. Goycoolea et al.
Table 1.1 (continued)
Complications
Inner ear Bezold’s abscess
Labyrinthitis Zygomatic abscess
Sensorineural hearing loss Postauricular abscess
Others
Developmental
Behavioral
Sequelae
Active
Recurrent attacks of otitis media
Chronic otitis media with effusion
Silent otitis media
Masked mastoiditis
Continuum of
POM-SOM-MOM-COM
Inactive
Atelectasis
Tympanosclerosis
Adhesive otitis media
a
Tympanic membrane
b
POM purulent otitis media, SOM serous otitis media, MOM mucoid
otitis media, COM chronic otitis media
b
Clinical Classication
The Task Force of the Fourth International Symposium of
Otitis Media, held in June 1987, at Bal Harbor, Florida, classied otitis on clinical grounds [4], as did the Task Force of
the Seventh Symposium in 1999 [5].
For purposes of communication and uniform reporting,
we have followed this classication, with a clear understanding, however, that it is a working classication that allows a
“common language” in the subject. It is important to men-
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