Chronic ear infection is inflammation or infection of the middle ear that persists or keeps coming back, and causes long-term or permanent damage to the ear.
See also: Acute ear infection
Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection
For each ear, a eustachian tube runs from the middle ear to the back of the throat. This tube drains fluid that is normally made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. When this happens, germs such as bacteria and viruses can multiply and cause an infection. This is called an acute ear infection (acute otitis media).
A chronic ear infection occurs when fluid or an infection behind the eardrum does not go away. A chronic ear infection may be caused by an acute ear infection that does not clear completely, or repeated ear infections. Fluid in the middle ear may become very thick. Sometimes, the eardrum (tympanic membrane) may stick to the bones in the middle ear.
A chronic ear infection may cause permanent changes to the ear and nearby bones, including:
"Suppurative chronic otitis" is a phrase doctors use to describe an eardrum that keeps rupturing, draining, or swelling in the middle ear or mastoid area and does not go away.
Ear infections are more common in children because their Eustachian tubes are shorter, narrower, and more horizontal than in adults. Chronic ear infections are much less common than acute ear infections.
A chronic, long-term infection in the ear may have less severe symptoms than an acute infection. It may go unnoticed and untreated for a long time.
Note: Symptoms may be continuous or come and go, and may occur in one or both ears.
An examination of the ear may show:
Tests may include:
The health care provider may prescribe antibiotics if the infection may be due to bacteria. You may need to take antibiotics for a long time, either by mouth or sometimes into a vein (intravenously).
If there is a hole in the eardrum, antibiotic ear drops are used. For a difficult-to-treat infected ear that has a hole (perforation), a dilute acidic solution (such as distilled vinegar and water) may be recommended by your health care provider.
A surgeon may need to clean out (debride) tissue that has gathered inside the ear.
Other surgeries that may be needed include:
Chronic ear infections usually respond to treatment. However, your child may need to keep taking medicines for several months.
Chronic ear infections are not life threatening, but they can be uncomfortable and may result in hearing loss and other serious complications.
Permanent hearing loss is rare, but the risk increases with the number and length of infections.
Call for an appointment with your health care provider if:
Getting prompt treatment for an acute ear infection may reduce the risk of developing a chronic ear infection. Have a follow-up examination with the health care provider after an ear infection has been treated to make sure that it is completely cured.
Chole RA, Sudhoff HH. Chronic otitis media, mastoiditis, and petrositis. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, Pa: Mosby Elsevier;2005:chap 133.
Morris PS, Leach AJ. Acute and chronic otitis media. Pediatr Clin North Am. 2009 Dec;56(6):1383-99.