Chronic Ear Infections

Chronic ear infection is the result of an ear infection that has left a residual injury to the ear. Chronic ear infection (or chronic otitis media) symptoms depend upon whether there is involvement of the mastoid bone and whether there is a hole in the eardrum. In addition, the hearing level depends on whether there has been injury to the middle ear bones as well as the eardrum. There may be drainage, hearing impairment, tinnitus (head noise), dizziness, pain, or rarely, weakness of the face. Most often there is simply hearing loss, discomfort, and occasionally some discharge.

When an acute infection develops in the middle ear (an abscessed ear), the eardrum may rupture, resulting in a perforation. This perforation usually heals. If it fails to do so a hearing loss occurs, often associated with head noise (tinnitus) and intermittent or constant ear drainage. Occasionally after an infection, skin from the ear canal may be stimulated to grow through a perforated eardrum into the middle ear and into the mastoid. When this occurs, a skin-lined cyst known as a cholesteatoma is formed. This cyst will continue to expand over a period of time and progressively destroy the surrounding bone. It usually destroys the middle ear bones first, followed by the mastoid. Cholesteatoma presents a grave danger to the inner ear and to the brain, as meningitis may result. If a cholesteatoma is present, drainage tends to be more constant and frequently has a foul odor.

Treatment of Chronic Ear Infection

Home Care of the Ear

If an eardrum perforation is present, you should prevent water from getting in to the ear canal. This can be avoided when showering or washing by placing cotton in the external ear canal and covering it with a layer of Vaseline. If you desire to swim, a custom made mold is helpful in keeping water out of the ear canal.

Avoid blowing your nose repeatedly in order to keep infection in the nose from spreading to the ear through the eustachian tube. If it is necessary to blow your nose, do not occlude or compress one nostril while blowing the other.

In the event of ear drainage, keep the ear clean by using a small cotton-tipped applicator at the very outer portion of the canal. Medication should be used if discharge is present or when discharge occurs. Cotton may be placed in the outer ear canal to catch discharge, but should not be allowed to completely block the canal.

Medical Treatment

Medical treatment, including oral medications and ear drops, will frequently stop the ear drainage. In addition, careful cleaning of the canal and the application of antibiotic powder or oral antibiotics may be necessary. If there is not continuing destruction of the ear by scarring, infection, or by cholesteatoma, and there is minimal hearing loss, medical treatment may be all that is necessary for chronic otitis media. Otherwise, surgery may be necessary.