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Table 1 Diagnostic criteria and severity scale for worse ear

From: Compared to placebo, long-term antibiotics resolve otitis media with effusion (OME) and prevent acute otitis media with perforation (AOMwiP) in a high-risk population: A randomized controlled trial

Diagnosis Definition Severity scale for worse ear.
Normal Absence of middle ear inflammation or infection, normal mobility on pneumatic otoscopy, and type A, C1 or C2 tympanogram. 0
Otitis media with effusion (OME) Fluid behind an intact tympanic membrane (TM), reduced mobility on pneumatic otoscopy or type B tympanogram, with or without mild bulging, and in the absence of signs or symptoms of acute infection. 1
Acute Otitis Media without perforation (AOMwoP) Fluid behind an intact TM, reduced mobility on pneumatic otoscopy or type B tympanogram, with moderate or marked bulging, with or without symptoms of acute infection and without signs of recent perforation. 2
AOM with perforation (AOMwiP) Discharge through a perforated TM for less than 6 weeks. 3
Chronic suppurative otitis media (CSOM) Discharge through a perforated TM for more than 6 weeks despite appropriate treatment for AOMwiP. 4