Chronic otitis media: Information & doctors

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

In chronic middle ear inflammation, inflammatory processes occur repeatedly within the middle ear . Doctors differentiate between various forms.

Find out more about the symptoms and treatment of middle ear inflammation and find selected doctors here.

ICD codes for this diseases: H65, H66, H67

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Article overview

What is chronic otitis media?

Chronic middle ear inflammation is also known medically as otitis media chronica. This is when the middle ear repeatedly suff ers from inflammation. This causes pain and reduced hearing ability.

Mittelohrentzündung
With middle ear inflammation, secretions form behind the eardrum © bilderzwerg / Fotolia

There are three different forms:

  • cholesteatoma
  • chronic mucosal suppuration
  • Chronic mucosal and bone suppuration

None of these forms can be cured without expert treatment. There is even a risk of serious complications such as

In the worst case, meningitis (inflammation of the meninges) or a brain abscess can occur.

What are the causes of chronic otitis media?

The various forms of chronic middle ear infection have different causes.

Repeated sinusitis or an acute middle ear infection trigger chronic inflammation of the mucous membrane and bone. This is often caused by

Accidents or injuries can cause an eardrum defect. However, this is rarely the cause of a chronic middle ear infection.

In children, nasal polyps are often the cause of chronic middle ear inflammation. Nasal polyps are enlarged tonsils that cause ventilation problems in the middle ear. Pressure equalization through the Eustachian tube (Eustachian tube) is also affected.

If germs such as bacteria enter the middle ear through the eustachian tube, there is a risk of chronic inflammation.

Causes of a cholesteatoma

As a rule, ventilation problems in the middle ear cause a cholesteatoma. This leads to negative pressure inside the middle ear. This causes the eardrum to be pulled into the middle ear area. The doctor then speaks of eardrum retraction. Such a retraction can sometimes result in a cholesteatoma.

Another possible cause is the appearance of a hole at the upper edge of the eardrum. In rare cases, it is caused by injuries such as fractures of the skull or temporal bone. In some people, cholesteatoma is congenital.

What are the symptoms of chronic otitis media?

Many patients do not even notice a chronic inflammation of their middle ear at first. In the early stages, the disease does not always cause pain. This is a big difference to acute middle ear inflammation, which starts suddenly and causes

  • sharp earache,
  • dizziness and
  • fever

and fever. The symptoms of chronic otitis media tend to occur gradually. Therefore, the chronic form is often already well advanced when it is diagnosed. Typical signs of chronic ear disease include

  • ringing in the ears,
  • a reduction in hearing ability,
  • persistent discharge of fluid from the ear canal and
  • the proliferation of inflamed tissue.

Chronic otitis media can also cause severe pain and dizziness. In contrast to the acute form, however, the symptoms progress much more slowly.

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When should a doctor be consulted?

If fluid is leaking from the ear, you should consult a doctor as soon as possible. The same applies to severe ear pain or a feeling of pressure in the ear.

Children in particular should consult an ear, nose and throat specialist who specializes in the treatment of chronic middle ear infections as soon as possible.

Diagnosis

The ear, nose and throat specialist will first ask about the patient's medical history. He will ask you about any previous or concomitant illnesses.

He will then use an ear microscope to examine the eardrum. There is usually a hole in the center. If, on the other hand, the doctor discovers a retraction pocket or an onion-like pearl tumor at the rear upper edge of the eardrum, this is an indication of a cholesteatoma.

Further diagnostic options include

are possible.

How is a chronic middle ear infection treated?

An acute middle ear infection can simply heal. Chronic otitis media, on the other hand, must be treated medically. Otherwise it cannot heal.

Sometimes this even requires an operation. This is done, for example, if oversized adenoids are responsible for the chronic middle ear infection. In the case of anatomical causes in adult patients, the nose and paranasal sinuses can also be treated surgically.

A rupture of the eardrum is often the cause of chronic otitis media. This leaves access to the middle ear open. Patients should therefore make sure that no water gets into their ears when washing their hair. If bacteria get into the middle ear as a result, there is a risk of the symptoms worsening. An acute attack of vertigo is also possible.

For this reason, you should wear a bathing cap when bathing or showering.

Special ear drops usually help against the discharge of pus. In the event of complications, the doctor will usually prescribe antibiotics.

Conclusion

The course of a chronic middle ear infection depends on the form of the disease. The timing of the start of treatment also plays an important role. The prognosis is most favorable in the case of chronic mucosal suppuration.

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