Repeated or lingering infections of the middle ear can cause damage, sometimes permanent, to the ear and nearby bones. Chronic ear infections are far more common in children than adults, and although they usually respond to treatment, they can be serious. Complications can include partial or total hearing loss, paralysis of the face, and slow development of language skills or speech.
Ear infections begin when the eustachian tube, which runs from the middle ear to the throat, becomes blocked. Children have narrower, shorter eustachian tubes than adults, making them more prone to blockage. Fluid that originates in the middle ear builds up because it can’t drain, and bacteria and viruses multiply. The result is an acute ear infection (“acute” because it’s considered short in duration until proven otherwise). If the infection doesn’t go away or it only partially goes away, to return time and time again, it is deemed “chronic.”
In a chronic ear infection, the fluid in the middle ear can become abnormally thick, causing the eardrum to stick to the neighboring bones. Other changes to the surrounding structures can occur. Bones can be worn down, soft tissues can harden, the eardrum can rupture (sometimes repeatedly), and infection can spread to the bone behind the ear.
Symptoms of chronic ear infection include pain, which can be mild or severe, fever, discharge from the ear, and crankiness—which is how kids often say “I’m in pain” when they lack the awareness to say just that.
Tests for chronic ear infection include a physical exam and culture of the discharge for bacteria, imaging of the head to see the extent of the infection and assess potential damage to structures of the ear, and hearing evaluation.
Dr. Yagoda is an otolaryngologist (ear, nose, and throat doctor) as well as a facial plastic surgeon in Manhattan/ NYC/ New York/ NY who can provide necessary treatments that go beyond the usual prescription for antibiotics. If necessary, she can provide surgical corrections to the structure of the middle ear, repairing or replacing damaged bones and cleaning out any infectious material.