What Causes Chronic Ear Infections?
Chronic otitis media (chronic ear infection) occurs when fluid behind your eardrum becomes infected and does not go away with antibiotics. Unlike swimmer’s ear that affects the external ear canal, a chronic middle ear infection can cause hearing loss, holes in the eardrum, and require surgery if severe.
Chronic ear infections cause severe damage and conductive hearing loss if left untreated. Conductive hearing loss happens when the fluid or infection behind your eardrum blocks sounds from reaching your inner ear. You can usually improve conductive hearing loss with surgery and treatment.
Eustachian tube dysfunction (ETD) is the most common cause of chronic ear infections. This structure drains fluid from the middle ear and equalizes pressure. In some individuals, the Eustachian tube does not function normally from birth. If the fluid becomes infected, pressure builds behind your eardrum, and that pressure may cause a perforation (hole) in the eardrum.
Chronic Ear Infection Symptoms
Symptoms may come and go, especially following a head cold or swimming. Persistent otorrhea (drainage) is the most common symptom of a chronic middle ear infection. The drainage is usually straw-colored but could look white or like pus or blood.
Chronic ear infection may cause other symptoms:
- hearing loss in your affected ear,
- feeling of fullness in your ear,
- pain and pressure in your ear, and
- one-sided tinnitus (ringing in one ear and not the other).
Dizziness or balance issues are usually not symptoms of chronic ear infections.
Signs of Chronic Ear Infections in Toddlers and Children
Children often get ear infections following a cold or upper respiratory infection. These are acute infections, meaning they come on quickly and get better with medication. Your child may have ear pain or fever with an acute infection. Often, your doctor may recommend the placement of PE (pressure equalization) tubes to help drain fluid and improve hearing if fluid in the ear stays for a long time.
Children with chronic infections that don’t go away or come back repeatedly even with treatment experience similar symptoms:
- difficulty sleeping
- drainage
- ear fullness
- fussiness
- trouble hearing
When to See a Doctor for Chronic Ear Infection
You should see an ENT (ear, nose, and throat) specialist if you experience any of the following warning signs:
- You have three or more ear infections in a year.
- Your primary care doctor finds a hole in your eardrum.
- Your symptoms don’t improve with oral antibiotics or eardrops.
- You’ve had ear surgery, but your symptoms return.
Why Choose University of Utah Health?
Neurotologists and otolaryngologists at University of Utah Health specialize in chronic or critical ear, nose, and throat problems. As a regional referral center, we care for the most complex cases in the Mountain West.
Our surgeons are fellowship-trained and board-certified or board-eligible in neurotology, a subspecialty branch of medicine that cares for skull base tumors, inner ear problems, and implantable hearing devices. They are highly experienced and perform hundreds of chronic ear infection surgeries each year.
Our multidisciplinary team includes audiologists and speech-language pathologists to help restore your hearing.
Find an Otolaryngologist Near You
How We Diagnose Chronic Ear Infections: Tests & Evaluations
Specialists diagnose chronic ear infections with physical exams and imaging tests. Your ear specialist will look inside your ear using a microscope, much like an eye doctor looks in the eye.
The microscopic ear examination will help your specialist see signs of a chronic ear infection:
- A hole (perforation) in your eardrum
- Fluid draining from your eardrum
- Redness
- Thick fluid
Your specialist may recommend other tests:
- Computed tomography (CT) scan
- Cultures of the ear fluid to look for bacteria
- A hearing evaluation
Chronic Ear Infection Treatment
Specialists use conservative treatments like oral medications and ear drops to treat chronic ear infections. If these options don’t work, you may need surgery. If you have a hole in your eardrum, surgery is often the only effective treatment option to reduce the chance of future infections.
Chronic Ear Infection Surgery
Neurotologists use microsurgical procedures to treat chronic ear infections. Depending on your condition, your specialist may perform one of the following surgeries:
- Tympanoplasty—Your surgeon repairs holes in your eardrum using a graft (piece of tissue) from your ear to reconstruct the eardrum.
- Tympanomastoidectomy—During this procedure, your surgeon repairs your eardrum and removes infection in the middle ear and mastoid bone. The bone is located behind your ear and contains tiny pockets of air, which may trap fluid or infection. Your surgeon will clean out the affected areas of bone using a special tool.
- Eustachian Tube Dilation—Your specialist may use balloon dilation to help your eustachian tubes stay open and drain properly. During the procedure, your specialist places an instrument called an endoscope into your nose and uses it to see your eustachian tube. Next, the specialist inflates a balloon inside the tube. After two minutes, they deflate they balloon and remove it through your nose. This procedure is often used in conjunction with tympanoplasty or tympanomastoidectomy.
Surgery Recovery
Most people go home on the same day as their surgery. You’ll have cotton or gauze in your ear canal when you leave the hospital. Your surgeon will let you know when it’s OK to remove it. It’s normal to feel dizzy for a few days and your ear may feel blocked. As your ear heals, these symptoms will improve. You may feel dizzy for a few days, and your ear may feel stuffy or blocked. These side effects will improve as your ear heals.
You’ll also need to avoid some activities for a few weeks:
- Air travel
- Strenuous activities
- Swimming or getting your ears wet
Your surgeon will provide complete instructions for aftercare.
How to Prevent Chronic Ear Infections
Because structural problems inside the ear often cause chronic ear infections, home remedies or lifestyle changes may not help you prevent them. The best defense is to contact a provider if you notice any symptoms of an ear infection.
But keeping your ears dry is essential if you are prone to ear infections. Wear earplugs when swimming, even in chlorinated pools, and avoid spraying water directly into your ear in the shower.
Schedule an Appointment With an ENT Specialist
If you have chronic ear infections, our ENT specialists can help you find relief from symptoms and prevent future infections. Your primary care provider or other specialist will need to refer you to one of our ENT providers for further evaluation and testing. If surgery is needed, your ENT specialist will refer you to one of our neurotologists (ENT surgeon).
To make an appointment, please call 801-587-8368 or request an appointment online. Use our online form to refer a patient to our ENT service.