Although chronic suppurative otitis media has been one of the oldest problems of otology, uncertainty still continues not only as to how to handle a given patient but also as to what constitutes the disorder. Diamant1 considered it impossible to give a definition that would cover both the clinical and pathologic aspects of the condition known as "chronic suppurative otitis media." Attempts to define it as a perforation of the drum membrane with intermittent or chronic discharge resulted in such advice as that of Sir Charles Ballance,2 who suggested that radical mastoidectomy with skin grafting should be done in any case of chronic suppurative otitis media for the safety of the patient. He based this advice on an analogy to chronic osteomyelitis of other bones and asked what surgeon would advise that a suppurating sinus tract be neglected. He was obviously lumping several distinct clinical and pathologic types
WILLIAMS HL. The Surgical Treatment of Chronic Suppurative Otitis Media. AMA Arch Otolaryngol. 1958;68(5):574–586. doi:10.1001/archotol.1958.00730020596006
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