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8. Impact and Sequelae

The panel feels that the sequelae and impact of chronic otitis media with effusion ( O M E ) should be assessed from the points of view of 1) the anatomical loci of disease, and 2) the behavioral functional ef­ fect on the child resulting from the damage conse­ quent to the disease at the anatomical locus. Using this structure the panel defined three anatomical loci at which chronic O M E has an effect that is felt to have consequences on the child in terms of se­ quelae and impact. These are the middle ear, the inner ear, and the central nervous system.