Chronic otitis media


What is it about ?

Chronic otitis media is a persistent infection of the middle ear that lasts for more than two months. Sometimes the infection appears to be cured, but it reappears. Without proper treatment, it can lead to permanent damage.

A chronic middle ear infection sometimes causes a yellowish or greenish discharge from the ear, which is the result of permanent perforation of the eardrum. A serious form is the cholesteatoma ; it is an accumulation of keratinized skin cells (which have turned into a horn) in the ear canal. Keratinized skin cells can develop in the middle ear and even in bone.

The bacteria that cause chronic otitis media are different from those that cause acute otitis media. Often, several types of germs are present at the same time.

How to recognize it?

If, occasionally or constantly, your ear has a purulent discharge with impurities, sometimes alternating with a clear or mucous discharge, you may have a chronic middle ear infection.

How is the diagnosis made?

The doctor can make the diagnosis based on your story and examining the external ear canal and eardrum. With a cotton swab, he can take a sample of the discharge from the ear for additional examinations to find out the bacteria and / or fungi responsible.

What can you do ?

Good hygiene is important to prevent contamination:

  • Regularly dab the liquid on the pinna.
  • Thoroughly clean up anything that has come in contact with the inflammatory fluid.
  • You can possibly cover the ear with a large bandage that you need to change regularly. A closed damp space is not ideal. It is therefore necessary from time to time to leave the ear in the air without bandage.
  • Swimming is not recommended.

Do not start using drops or taking antibiotics yourself.

What can the doctor do?

The doctor may rinse the ear and prescribe treatment with ear drops.

First heat the bottle with the ear drops in the palms of your hands before putting them into the ear canal. This prevents dizziness caused by the cold. After putting the drops in the ear, it is important to lie down for 5 minutes so that the drops do not come out immediately.

Once the responsible bacteria are known, treatment can be adjusted if necessary.

Antibiotics are sometimes prescribed. For example in case of profuse and persistent ear discharge.

After ten days of treatment, you must have a check-up with the doctor. The treatment will be adapted according to the result. If the ear continues to flow after ten days of treatment, you will be referred to an ENT specialist (otolaryngologist, ear, nose and throat specialist).

In the presence of any of the following symptoms, the doctor will certainly refer you to an ENT:

  • worsening of the general condition, severe ear pain or headaches,
  • facial paralysis,
  • dizziness,
  • discharge from the ear for more than 4 weeks,
  • perforation of the eardrum that has not closed after 3 months,
  • cholesteatoma.

Want to know more?

Source

Foreign clinical practice guide ‘Chronic otitis media’ (2000), updated on 24.04.2016 and adapted to the Belgian context on 16.06.2018 – ebpracticenet