Otorrhea natural history, complications and prognosis
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Overview
Instead of the infection and eardrum perforation resolving, however, drainage from the middle ear can become a chronic condition. As long as there is active middle ear infection, the eardrum will not heal. The World Health Organization defines Chronic Serous Otitis Media (CSOM) as 'a stage of ear disease in which there is chronic infection of the middle ear cleft, a non-intact tympanic membrane (i.e. perforated eardrum) and discharge (otorrhoea), for at least the preceding two weeks' (WHO 1998). (Notice WHO's use of the term "serous" to denote a bacterial process, whereas the same term is generally used by ear physicians in the United States to denote simple fluid collection within the middle ear behind an intact eardrum. "Chronic otitis media" is the term used by most ear physicians worldwide to describe a chronically infected middle ear with eardrum perforation.)