Fig. 3.

Inter-related phenotypes of mucosal OM, together with their known or presumed risk factors. In this schematic, white broken arrows denote postulated links between OM-related conditions and unbroken arrows represent known links. Risk factors and therapies associated with pathogen exposure (left) and with host characteristics and inflammatory response (right) for acute and chronic forms of OM are shown. There are two forms of chronic mucosal OM: COME (chronic OM with effusion) and CSOM (chronic suppurative OM). Note that OME and COME can occur without antecedent AOM. The causes of CSOM are not well understood. AOM, acute otitis media; rAOM, recurrent AOM.