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Otitis media; chronic Causes and Risks:
Any acute ear infection may become chronic . A chronic ear infection (chronic otitis media) may be more dangerous than acute ear infection because its effects are prolonged or repeated and may cause permanent damage to the ear. Chronic infections may show less severe symptoms and may not be noticed, so the infection may remain untreated for long periods of time.
Occasionally, trauma or other disorders may cause chronic ear infection. Swelling of the adenoids blocks the eustachian tubes (the passage between the inner ear and the back of the nose/ upper throat) and may cause chronic inflammation (serous
otitis). This is most common in children. The eustachian tube may be blocked repeatedly or may be scarred from previous infections, allergies , or swelling in the back of the throat.
Chronic otitis media, where the middle ear is actually infected with bacteria (or, occasionally, viruses) rather than just inflamed, is more serious. It may be the result of an acute ear infection that does not clear completely, or the result of recurrent ear infections . The infection may spread into the mastoid bone ( mastoiditis ), or pressure from fluid build-up may rupture the eardrum or damage the bones of the middle ear.
Chronic ear infection is much less common than acute ear infection. It affects approximately 2 out of 10,000 people.
Prevention:
Prompt treatment of acute ear infections may reduce the risk of development of chronic otitis media. Follow-up examination after treatment of an ear infection will ensure that it is completely cured.
Symptoms:
Note: Symptoms may be continuous or intermittent, and may occur in one or both ears.
Signs and Tests:
An inspection of the ear may show dullness, redness, air bubbles, or fluid behind the eardrum. The eardrum commonly shows drainage or perforation (a hole in the eardrum). The eardrum may bulge out or retract inward.
Cultures of drainage may show bacteria; these bacteria may be resistant or harder to treat than the bacteria commonly involved in acute ear infection .
Head X-rays or a CT scan of the head may show spread of the infection beyond the middle ear.
Treatment:
Treatment is focused on relief of symptoms and cure of the infection.
Decongestants or antihistamines may be used to aid drainage through the eustachian tube. Antibiotics may be prescribed if the infection appears bacterial. Antibiotic treatment is usually long-term and may be oral or in the form of antibiotic ear drops.
Surgical removal of the adenoids may be necessary to allow the eustachian tube to open. Surgical opening of the eardrum ( myringotomy ) may be used to allow fluid to drain; this may or may not include placement of drainage tubes in the ear. Surgical repair of a ruptured eardrum may prevent recurrence of chronic ear infection.
Keep the ears clean and dry to prevent reinfection. This is particularly important if myringotomy has been performed.
Prognosis:
Chronic otitis usually responds to treatment, but treatment may be prolonged (over several months). The disorder is usually not a threat to life but may be uncomfortable and may result in serious complications.
Complications:
Call Your Healthcare Provider:
Call for an appointment with your health care provider if you have signs of chronic otitis media (including an episode of acute otitis media that does not respond to treatment).
Call your health care provider if chronic otitis media does not respond to treatment, or if new symptoms develop during or after treatment of this disorder.
This is an illustration of the external, middle, and inner ear. The detailed section is of the eardrum and the three tiny bones that conduct sound from the drum to the cochlea.
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