Chronic suppurative otitis media is clinically divided into two types with different anatomical involvement, perforation patterns and complication risks.
Tubotympanic type
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The tubotympanic type is called safe or benign. It involves the anteroinferior middle ear cleft, including the eustachian tube and mesotympanum.
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It is associated with a central perforation. The source describes no risk of serious complications.
Atticoantral type
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The atticoantral type is called unsafe or dangerous. It involves the posterosuperior cleft, including the attic, antrum and mastoid.
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It is associated with an attic or marginal perforation and often with a bone-eroding process such as cholesteatoma, granulations or osteitis.