Chronic ear infection refers to both an ear infection that does not heal and a recurring ear infection. This may also be known as recurring acute otitis media. The middle ear, the space behind the eardrum, is affected by this infection.
The Eustachian tube, a tube that normally drains fluid from the middle ear, can become plugged and infected. This buildup of fluid in the middle ear presses on the eardrum, causing pain. If left untreated, an infection can cause the eardrum to rupture. Eustachian tubes in children are smaller and more horizontal, so they can become plugged more easily. This is why ear infections occur more commonly in children.
A chronic ear infection can cause milder symptoms than an acute ear infection. Symptoms may affect one or both ears and may be constant or come and go. Signs that you may have a chronic ear infection include:
- a feeling of pressure in the ear
- mild ear pain
- fluid draining from ears
- low fever
- hearing loss
- trouble sleeping
An infant may seem fussier than usual, especially when lying down, as this puts pressure on the ear. Your baby’s eating and sleeping habits may also change. Pulling and tugging on the ear can also be a sign of a chronic ear infection in infants. However, this can also be caused by teething or exploration of the body.
If you or your child is having symptoms of an acute ear infection, which includes ear pain, fever, and trouble hearing, you should see your doctor. Getting an acute ear infection treated promptly can help prevent a chronic ear infection. You should also see your doctor if:
- you have been diagnosed with an acute ear infection but it’s not responding to treatment (antibiotics)
- you have been diagnosed with an acute ear infection and experience new symptoms, or if the symptoms get worse
- if your child shows symptoms of a recurring ear infection
Chronic ear infections require medical treatment. However, home treatment can help relieve your symptoms. Home treatment includes:
- holding a warm or cool washcloth to the painful area
- using numbing ear drops
- taking an over-the-counter pain reliever, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
If you have a chronic ear infection, your doctor will prescribe antibiotics. These may be taken orally or given intravenously (in a vein) if the infection is severe. Your doctor may suggest ear drops if you have a hole (perforation) in the eardrum. Antibiotic ear drops can also be used, or your doctor may suggest using a diluted vinegar solution.
Surgery may be needed for chronic ear infections that aren’t responding to treatment or are causing hearing problems. Hearing problems can be especially problematic in children because they can cause speech and language problems at an important time in development.
Your doctor may wish to go in surgically and insert a small tube through the eardrum, connecting the middle ear and the outer ear. Inserting ear tubes helps the fluid in the inner ear drain, which can reduce the number of infections and the severity of symptoms. Ear tubes are usually placed in both ears. This procedure is called a bilateral myringotomy.
To do this procedure, a surgeon will make a tiny hole in the eardrum. The fluid will be suctioned out of the ear, and a small tube will be inserted through the hole. Tubes usually fall out on their own, about six to 18 months after they are inserted. If the tubes don’t fall out, you may need to have them surgically removed.
Other types of surgery may be required if the infection has spread. There are a number of small bones in the middle ear. If these bones become infected, surgery may be required to repair or replace them. The eardrum can also be damaged by a chronic ear infection. If the eardrum isn’t healing properly, you may need surgery to repair damage.
Rarely, the infection can spread to the mastoid bone, a bone located behind the ear. If the infection spreads to the mastoid bone, surgery is required to clean out the infection. This is known as a mastoidectomy.
If left untreated, a chronic ear infection can cause a number of problems. These possible complications include:
- hearing loss
- damage to the bones in the middle ear
- infection of the mastoid bone
- damage to the balance function in the ear
- drainage from hole in eardrum
- tympanosclerosis, a hardening of tissue in the ear
- cholesteatoma, a cyst in the middle ear
- facial paralysis
- inflammation around or in the brain
There are a number of things you can do to help reduce you and your child’s risk of developing a chronic ear infection. Make sure to talk to your doctor if you have an acute ear infection so it can be treated and doesn’t become chronic.
It’s also important to stay up-to-date with vaccinations for influenza, pneumonia, and meningitis — the viruses and bacteria these vaccines protect you from can also cause ear infections. In fact, pneumococcal bacteria, which can cause both pneumonia and pneumococcal meningitis, also causes about half of middle ear infections, according to the Centers for Disease Control and Prevention.
Other tips for preventing ear infections include:
- stopping smoking and avoiding secondhand smoke
- breast-feeding infants for the first year of life
- practicing good hygiene, including washing hands regularly