Chronic ear infection refers to an ear infection that does not heal, or recurring ear infections. 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 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 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 is 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 are not 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 ear drum 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 do not fall out, surgery may be required to remove the tubes.
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 is not healing properly, surgery may be required 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. These include:
- treating acute ear infections
- stopping smoking and avoiding secondhand smoke
- breastfeeding infants for the first year of life
- practicing good hygiene, including washing hands regularly
- getting vaccines for influenza, pneumonia, and meningitis