What is Chronic Otitis Media?

Chronic otitis media is some of the ongoing difficulties with the middle ear, like a hole (perforation) in the eardrum that doesn't heal, or a recurrent (persistent or repeating) infection of the middle ear (otitis media) that does not get better.

The middle ear is a tiny bony cavity with three small bones — the malleus, incus, and stapes — covered by the eardrum (tympanic membrane). Sound is transmitted from the eardrum to the middle-ear bones to the inner ear, where the nerve impulses for hearing are generated. The middle ear is linked to the back of the nose and throat via the eustachian tube, a small tube that assists in regulating the air pressure and flow within the middle ear. The middle ear may become infected or inflamed when the eustachian tube is blocked, such as when a person has a cold or allergies. When fluid is in the middle ear, chronic serous otitis media is diagnosed.

What are the symptoms of chronic otitis media?

A person might have chronic otitis media from a long-standing hole in the eardrum for years with no symptoms at all or a mild hearing loss. Mild ear pain or discomfort may be present. When infection of the middle ear occurs, fluid will pour out of the ear and worsening of hearing is possible.

The following symptoms, which can indicate a more dangerous condition, and which need prompt attention, include:

Severe pain, dizziness, and facial nerve damage (facial weakness)
Swelling, redness, and tenderness behind the ear, which can be a sign of infection spread to the mastoid bone (mastoiditis)
Fever, headache, and confusion.

What causes chronic otitis media?

Chronic otitis media usually develops from an acute middle ear infection. In other instances, a blow to the ear or an obstruction of the Eustachian tube—the tube that leads from the back of the nose to the middle ear—is the cause of chronic otitis media.

Any adult may have chronic otitis media, but risk is higher in individuals who:

Smoke or are regularly exposed to smokers
Have year-round or seasonal allergies
Are constantly exposed to air pollution

How is chronic otitis media diagnosed?

The physician will inquire about a history of ear infections, the treatments that have been used, and past ear surgery. The physician also will inquire about any medications taken to cure an ear issue, including the dose, type, and duration of treatment.

The physician can suspect chronic otitis media on the basis of a history of previous ear infections, ongoing ear drainage, or both. To make a diagnosis, they will examine the inside of the ear with a light called an otoscope and possibly obtain a sample of drainage fluid to be sent to a lab for examination.

In a few cases, doctor may refer you or your child to an otolaryngologist, a physician who specializes in the treatment of ear, nose, and throat disorders. If the otolaryngologist suspects mastoiditis or a cholesteatoma, further tests may be required. These might be x-rays, a computed tomography (CT) scan, or a magnetic resonance imaging (MRI) scan. If there is any suspicion that hearing has been impaired, it can be assessed by a test known as an audiogram.

What is the expected duration of chronic otitis media?

Duration of symptoms is variable. Treatment of the infection that leads to chronic otitis media with antibiotics may be sufficient to prevent the ear from draining. Sometimes, even on proper antibiotics, the infection persists, and surgery can be required to remove the infected tissue and close the eardrum perforation and damage to the small bones in the ear.

What is the treatment for chronic otitis media?

The aims of treatment for chronic otitis media are:

Eradicating persistent infection
Reducing drainage from the ear
Curing the eardrum (tympanic membrane)
Preventing repeated infection to prevent complications.

Topical antibiotics are commonly attempted first in most case. The physician usually selects a fluoroquinolone antibiotic solution, such as ciprofloxacin. For severe infections, an oral antibiotic will be required.

Also, the physician will aspirate middle-ear fluid that is draining. Most of the infections will resolve with this care unless a cholesteatoma is involved. A cholesteatoma can lead to recurrent infections and usually must be removed surgically.

A physician can prescribe surgery to fix a recurring hole in the eardrum. In other situations, though, the hole is not closed since it can function as a tympanostomy tube to provide a passage for air through the middle ear and potentially avoid further infection.

When a persistent ear infection invades beyond the middle ear into the mastoid bone (the area of bone located behind the middle ear), a severe infection called mastoiditis can take place. In many cases, antibiotics administered intravenously (into the bloodstream) can be used to resolve this infection, but surgery can be required.

How is chronic otitis media prevented?

One of the best prevention methods for chronic otitis media is to treat any ear infection early. A child with recurrent eustachian tube issues might require special tubes (tympanostomy tubes) to be placed in his or her eardrums to avoid repeated ear infections by permitting air to pass normally through the middle ear.

Once an infection has cleared, a perforated eardrum might have to be fixed to avoid another infection.

What is the prognosis for chronic otitis media?

With early antibiotic treatment and ear drainage, the prognosis is very good. 9 of 10 patients are cured of infection with this treatment. Most of the time, surgery is not needed, but sometimes surgery is needed to repair a recurrent eardrum perforation or to take out a cholesteatoma. After such surgery, the infection usually resolves. Whether complete hearing returns or not depends upon the extent of damage and the healing of the ear after surgery.

When should I call a doctor?

Seek an immediate call from your doctor if your child or you develop an ear discharge that is cloudy and/or has an odor from either ear or has difficulty hearing. Additionally, have emergency help for fever, swelling, pain or redness behind the ear, earache that persists and is severe, dizziness, headache, confusion, or facial weakness.

Why Tender Palm Super-Speciality Hospital for Chronic Otitis Media treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital has the most trusted team of ENT Specialist and surgeons with advanced diagnostic equipment care for Chronic Otitis Media treatment in Lucknow, India. Our ENT department follows international safety standards and has years of experience in successfully managing ear related disease and conditions.