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Chronic otitis media describes some long-term problems with the middle ear, such as a hole (perforation) in the eardrum that does not heal or a middle ear infection (otitis media) that doesn't improve or keeps returning. The middle ear is a small bony chamber with three tiny bones – the malleus, incus and stapes – covered by the eardrum (tympanic membrane). Non-infected chronic otitis media – There is a hole in the eardrum but no infection or fluid in the middle ear.
Suppurative (filled with pus) chronic otitis media – This happens when there is a hole in the eardrum and an infection in the middle ear. Chronic otitis media with cholesteatoma – A persistent hole in the eardrum sometimes can lead to a cholesteatoma, a growth (tumor) in the middle ear made of skin cells and debris.
Problems with the middle ear, such as fluid in the middle ear, a hole in the eardrum, or injury to the small, middle ear bones, can cause hearing loss.
A person can have chronic otitis media caused by a persistent hole in the eardrum for years with no symptoms or only mild hearing loss. The doctor will ask about a history of ear infections, treatments used, and any previous ear surgery. In some cases, the primary care doctor may refer you or your child to an otolaryngologist, a doctor who specializes in treating disorders of the ears, nose and throat. One of the best ways to prevent chronic otitis media is to have any ear infection treated promptly.
After an infection clears up, a perforated eardrum may need to be repaired to prevent another infection. Suppurative chronic otitis media usually is treated with antibiotics taken by mouth and antibiotic eardrops. When a chronic ear infection spreads beyond the middle ear to the mastoid bone (the portion of bone behind the middle ear), a serious infection called mastoiditis can occur. Call your doctor immediately if you or your child develops a cloudy or foul-smelling discharge from one or both ears or has difficulty hearing.


Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional.
The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Sound is passed from the eardrum through the middle ear bones to the inner ear, where the nerve impulses for hearing are created. In rare situations, infections in the middle ear can spread deeper inside the inner ear, causing a sensorineural hearing loss and dizziness. The doctor also will want to know about any medications being taken to treat an ear problem, including the type, dose, and length of treatment. To confirm the diagnosis, he or she will look inside the ear with a special light called an otoscope and may take a sample of drainage fluid to be examined in a laboratory.
If the otolaryngologist suspects mastoiditis or a cholesteatoma, additional tests may be needed. Antibiotic treatment of the infection causing the chronic otitis media may be enough to stop the ear from draining. A child with chronic Eustachian tube problems may need special tubes (tympanostomy tubes) inserted into his or her eardrums to prevent repeated ear infections by allowing air to flow normally in the middle ear. However, in some cases, the hole is left open because it can act like a tympanostomy tube to allow air to flow through the middle ear and possibly prevent more infections.
Antibiotics given intravenously (into a vein) often can clear up this infection, but surgery may be necessary.
Also, seek emergency care for fever, swelling, tenderness or redness behind the ear, persistent or severe ear pain, dizziness, headache, confusion, or facial weakness.
This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
The middle ear is connected to the back of the nose and throat by the Eustachian tube, a narrow passage that helps to control the air flow and pressure inside the middle ear.


Rare, but serious, complications include brain infections, such as an abscess or meningitis.
When the middle ear is infected, fluid will drain from the ear and hearing loss can worsen. These could include X-rays, a computed tomography (CT) scan, or a magnetic resonance imaging (MRI) scan.
Sometimes, despite appropriate antibiotics, the infection continues, and surgery may be needed to remove the infected tissue and repair the eardrum perforation and any injury to the tiny bones in the ear.
Surgery usually is necessary to correct a persistent eardrum perforation or to remove a cholesteatoma.
The middle ear can become inflamed or infected when the Eustachian tube becomes blocked, for example, when someone has a cold or allergies.
Cholesteatomas can cause hearing loss and are prone to get infected, which can cause ear drainage. A chronic infection and a cholesteatoma also can cause injury to the facial nerves and facial paralysis. If there is any concern that hearing may have been affected, it can be evaluated by a test called an audiogram. Cholesteatomas will grow large enough to erode the middle ear structures and the mastoid bone behind the middle ear. Whether full hearing returns depends on the extent of damage and how well the ear heals after surgery.



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