Recurring Ear Infections

Chronic or recurring ear infections occur because of bacteria, inflammation and fluid build-up in the ear and can result in permanent damage to the ear and hearing loss. The three primary types of recurring ear infections include chronic otitis media, secretory otitis media and otitis externa.

Function

• The ear divides into three different sections: the outer ear canal; the middle ear space, the prime location for infections; and the inner ear, where the nerve and balance center is. The eardrum, a thin membranous tissue, divides the outer and middle sections of the ear. The middle ear space is connected to the back of the nose by the Eustachian tube. The Eustachian tube is the conduit for bacteria and viruses to enter the mouth and develop inside the ear.

Chronic Otitis Media

• Chronic otitis media is a recurring or long-term infection that results in inflammation of the inner ear. Symptoms include a hole in the eardrum, scarring or erosion of the bones in the ear, chronic or recurring drainage, inflammation that causes erosion to the balance canals, cochlea (the hearing organ) or facial nerve. Chronic otitis media occurs when the Eustachian tube becomes blocked from the back of the nose. Treatment includes antibiotics, ear drops and ventilation tubes.

  Doctors will recommend surgery if the patient has regular infections or if there has been significant damage to the eardrum. The first stage of the surgery removes the abnormal tissue and the latter reconstructs damaged areas, repairing the eardrum and providing hearing improvement. Because the infection can recur, regular checkups are important to ensure that healing is successful and to prevent additional infections by cleaning the ear regularly.

Secretory Otitis Media

• Secretory otitis media is usually caused by a previous ear infection, gastroesophageal reflux disease, or a blocked Eustachian tube. This condition most often occurs after a case of acute otitis media, during which fluid has accumulated behind the eardrum and must then be drained. This can happen even after the acute ear infection has resolved itself and may recur if not properly treated.

  Secretory otitis media will sometimes cause no pain, but can impair hearing. It often resolves itself and routine antibiotics or other medications typically do not work. Unfortunately, the infection can become chronic or recur so frequently that drainage tubes need to be inserted to remove the accumulated fluid and prevent further infection. Drainage tubes are a part of a successful recovery from secretory otitis media and if not implanted, the infections may continue and cause permanent hearing loss.

Otitis Externa

• Otitis externa is an infection of the outer ear canal. Symptoms include ear pain, discharge, sensitivity to pressure or touch and itching. Otitis externa is caused by ear damage, and if damage continues, this condition can become a chronic condition. Treatments include a thorough ear cleaning by the doctor, antibiotic ear drops, antifungal ear drops and corticosteroids for itching. If the infection persists, a doctor will most likely check for other problems such as fungal infections, since they are resistant to antibiotics; middle ear infections; a ruptured eardrum; and skin disorders that cause inflammation.

Treatment

• Although some ear infections will resolve on their own, antibiotics may be necessary. Over-the-counter pain medication and prescribed ear drops reduce irritation and inflammation caused by the ear infection. If recurring ear infections are a problem, surgery to insert tubes to help decrease the pressure and fluid in the ear may help. This method often resolves any hearing loss and helps diminish the frequency of infection.

Diagnosis

• Diagnosis of recurring ear infection requires regular examinations of the ear. The physician may need to remove wax buildup in order to see clearly and will use an otoscope to look inside the ear. The otoscope reveals signs of damage and determines if an ear infection is present while eliminating ear drum rupture. A doctor may also use a pneumatic otoscope, which pushes air into the ear and allows the physician to measure the eardrum's pressure.

  Physicians may use a small probe during a procedure called tympanometry to examine the ear canal, detect if fluid is present in the middle ear or if there is something obstructing the Eustachian tube. In some cases, fluid may need to be drawn from the ear in order to determine what bacteria is present and relieve ear pain.

  Hearing tests evaluate if the ear infections have affected the ability to hear.