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Chronic Ear Infections

A chronic ear infection is an infection of the middle ear that either does not go away or keeps recurring. If untreated, it can permanently damage the ear.

Symptoms of Chronic Ear Infections

A chronic ear infection can have milder symptoms than an acute ear infection. They can affect one or both ears, and they may persist or come and go. The symptoms of a chronic ear infection can include the following:

  • Mild pain or discomfort in the ear that often feels like pressure
  • Hearing loss
  • Pus draining from the ear
  • In children, fever or fussiness in babies
  • Balance problems
  • Rarely, facial weakness

Chronic Ear Infection Causes

Ear infections, whether acute or chronic, are caused by blockages in or around the Eustachian tube. Under normal conditions, the middle ear is supposed to be well ventilated by air that keeps it warm and dry. If the Eustachian tube gets clogged, the middle ear gets damp and stagnant and thus becomes a good breeding ground for germs.

Colds, sinus infections, allergies, post nasal drip, and adenoid problems can all cause the Eustachian tube to get clogged. In children, upper respiratory infections caused by viruses, like colds, are the most common cause of ear infections. The defense systems of the Eustachian tube and middle ear are weakened and thus allow bacteria that typically live in the nose to invade the middle ear.

In many cases, a chronic ear infection is caused by an acute ear infection that failed to completely clear up. The Eustachian tube remains blocked, and the mucous secretions within the middle ear become thicker, which makes it harder for them to drain. The middle ear becomes and remains inflamed, and the altered pressure within it eventually affects the eardrum. Over time, the ear drum becomes deformed or even ruptures. The hole in the ear drum lets in water and bacteria.

Untreated chronic ear infections can erode the walls of the middle and inner ears and the ossicles. In rare, severe cases, the infection can go deeper into the head and eventually cause a brain abscess or meningitis.

Treatment

The doctor will begin by evaluating the patient. They will ask for a medical history and then examine the patient’s ear, nose and throat. The doctor may also order tests like an audiogram and tympanometry, which is a procedure that measures pressure in the middle ear.

There are a number of treatments, and the ones used will depend on how advanced or severe the infection is. If the infection is still in the early stages, the doctor will try to treat the cause of the Eustachian tube blockage. Medication for allergies may be prescribed. The doctor may also recommend ventilation tubes to promote normal air circulation until the infection clears.

If the eardrum or ossicles have been damaged, the doctor will prescribe antibiotics that can take the form of oral medications and/or ear drops. After the infection is under control, the patient will need surgery to repair the damage. The doctor will remove any abnormal tissues and rebuild the ear drum and other parts of the middle ear. An impressive 90-95 percent of such surgeries are successful, but it can take a couple months for the patient to regain their hearing.