[Extract] In Reply: Dugdale correctly refers to the natural history of chronic suppurative otitis media (CSOM), and the spectrum of endpoints. The primary endpoint chosen in our trial after ototopical treatment was a dry ear (commonly referred to as a "clinical cure" by other trials), an outcome to be expected after short-term follow-up. Surgical closure of the tympanic membrane (TM) has also been defined as "curing" CSOM. Attaining a dry ear is essential to TM healing, and is therefore a functionally important outcome.