Chronic middle ear infection is also known medically as otitis media chronica. This term is used when the middle ear suffers from recurring inflammation. This causes pain and reduced hearing ability
In a middle ear infection, secretions build up behind the eardrum © bilderzwerg / Fotolia
There are three distinct forms:
- cholesteatoma
- chronic mucosal suppuration
- chronic mucosal and bony suppuration
Without expert treatment, none of these forms can be cured. There is even a risk of serious complications such as
In the worst-case scenario, meningitis (inflammation of the meninges) or a brain abscess may develop.
The various forms of chronic middle ear infection have different causes.
Recurrent sinus infections or an acute middle ear infection can trigger chronic suppuration of the mucous membranes and bone. This is often caused by
- defects in the nasal septum,
- tumors within the nasopharynx (ENT tumors), or
- allergies such as hay fever.
Accidents or injuries can cause a perforated eardrum. However, this is rarely the cause of chronic otitis media.
In children, nasal polyps are often the cause of chronic otitis media. Nasal polyps are enlarged adenoids that result in impaired ventilation of the middle ear. In addition, pressure equalization through the Eustachian tube is impaired. If germs such as bacteria enter the middle ear through the Eustachian tube, this can lead to 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. As a result, the eardrum is pulled inward into the middle ear. Doctors refer to this as eardrum retraction. This retraction can sometimes lead to a cholesteatoma.
Another possible cause is the formation of a hole in the upper edge of the eardrum. In rare cases, it is caused by injuries such as fractures of the skull or the temporal bone. In some people, a cholesteatoma is present from birth.
Many patients do not initially notice that they have a chronic middle ear infection. In the early stages, the condition does not always cause pain. This is a major difference from acute otitis media, which begins suddenly and
- sharp ear pain,
- dizziness, and
- fever
. The symptoms of chronic otitis media tend to develop gradually. As a result, the chronic form is often already quite advanced by the time it is diagnosed. Typical signs of this chronic ear condition include:
- ringing in the ears,
- hearing loss,
- persistent discharge of fluid from the ear canal, and
- the proliferation of inflamed tissue.
In addition, severe pain and dizziness are also possible with chronic otitis media. Unlike the acute form, however, the symptoms progress much more slowly.
If fluid is draining 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.
Especially in children, you should promptly consult an ear, nose, and throat (ENT) specialist who specializes in the treatment of chronic middle ear infections.
The ENT specialist will first review the patient’s medical history. They will ask you about any pre-existing or concurrent conditions.
Using an otoscope, they will then examine the eardrum. In most cases, there is a hole in the center. However, if the doctor discovers a retraction pocket or an onion-shaped pearl-like growth at the upper rear edge of the eardrum, this is an indication of a cholesteatoma.
Other diagnostic options include
may be considered.
An acute middle ear infection can resolve on its own. In the case of chronic middle ear infection, however, the underlying causes must be treated medically. Otherwise, it will not heal.
Sometimes this even requires surgery. This is done, for example, when enlarged adenoids are responsible for the chronic middle ear infection. In cases where the cause is anatomical in adult patients, the nose and sinuses can also be treated surgically.
A perforated eardrum is often the cause of chronic middle ear infection. This leaves the middle ear exposed. The patient should therefore take care to ensure that no water enters the ears when washing their hair. If bacteria enter the middle ear as a result, there is a risk that the symptoms will worsen. An acute episode of dizziness is also possible. For this reason, you should wear a shower cap when bathing or showering.
Special ear drops usually help reduce pus discharge. In the event of complications, the doctor will typically prescribe antibiotics.
The course of a chronic middle ear infection depends on the type of infection. The timing of the start of treatment also plays an important role. The prognosis is most favorable in cases of chronic mucosal suppuration.
What is an ear infection?
An ear infection is an inflammation of the middle ear, medically known as otitis media. The condition often develops after a cold or an upper respiratory tract infection. It can affect both children and adults.
What are the symptoms of an ear infection?
Typical symptoms of an ear infection include ear pain, fever, a feeling of pressure, and hearing loss. In cases of acute ear infection, discharge may also come from the ear. Some people also complain of severe ear pain and a general feeling of being unwell.
How is an otitis media treated?
Treatment for otitis media depends on the cause and course of the condition. For uncomplicated cases of otitis media, pain relievers, rest, and measures to reduce swelling—which help improve ventilation of the middle ear—are often effective. In cases of bacterial infection, treatment often involves antibiotics.
How long does a middle ear infection last?
The duration of a middle ear infection depends on its severity and the causative agent. Acute otitis media often resolves within a few days to weeks. Chronic otitis media or recurrent middle ear infections, on the other hand, often require longer-term treatment under medical supervision.
Can middle ear infections be prevented?
To prevent middle ear infections, infections should be treated early and risk factors such as exposure to smoke should be reduced. Good ventilation of the Eustachian tube is especially important for babies and toddlers. Recognizing a middle ear infection and seeking early treatment can help prevent complications.
