A CLINICAL PROFILE OF OTITIS-MEDIA WITHOUT AN INTACT TYMPANIC MEMBRANE

An otitis media with effusion algorithm developed by Paradise et al ha s become the basis for many studies of otitis media. However, it has b een shown to be too ambitious (low specificity) and too optimistic (ab sence of fluid does not necessarily mean normal ears). We developed a four-point profile to characterize the condition of the middle ear, bu t it cannot be used when the eardrum is perforated (with a functioning tube or chronic perforation). We propose a three-point profile for us e without an intact tympanic membrane, and we report the validation of the profile by findings at myringotomy and by the preoperative profil e. This postoperative profile and the previously described profile for ears with an intact tympanic membrane should increase the accuracy of middle ear assessment in following the course of otitis media over ti me.