Table of ContentsView AllTable of ContentsWhat Is a Chronic Ear Infection?SymptomsDiagnosisTreatmentComplicationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is a Chronic Ear Infection?
Symptoms
Diagnosis
Treatment
Complications
Frequently Asked Questions
When anear infectiondoes not go away or keeps coming back, it is called a chronic ear infection. It often involves a hole in the eardrum, the tissue that separates the outer ear and middle ear, that does not heal.
There are three common types of ear infections, but the one that affects themiddle ear, known as otitis media, is the most common. The middle ear is the space behind theeardrum. It can become infected if theeustachian tube, which drains fluids from the middle ear, becomes blocked. The buildup can apply pressure on the eardrum, which can result inearache.
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Otitis media with effusion can occur after an infection has cleared up but fluid remains trapped in the middle ear. When it becomes chronic, it is referred to as chronicchronic otitis media with effusion (COME).
Acute otitis media can also lead to chronic suppurative otitis media (CSOM), in which ear discharge does not go away or it keeps coming back. CSOM is considered a complication of a middle ear infection.The discharge in CSOM continues to leak out through a hole in the eardrum.
What Causes Ear Infections?
While ear infections are incredibly common, they tend to heal fairly quickly. To be considered chronic, the symptoms have to last for at least three months.
The problem with chronic ear infections is that they don’t always present with the same symptoms as an acute ear infection, or the symptoms are much milder. Because of this, many people are unaware that they have a chronic ear infection. The symptoms of a chronic ear infection can include:
If a young child or infant has a chronic ear infection, they will likely have these signs of discomfort:
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How to Relieve Ear Pressure
The diagnostic process will typically involve various tests to examine the eardrum in greater detail. Your primary care physician will look into the affected ear with an otoscope, a small medical device that shines a light into the ear and helps the doctor view the ear canal and eardrum. They will look for:
When to See a Doctor
Treatment for a chronic ear infection depends on what is causing it. For example, if bacteria are to blame, antibiotics will be prescribed. If the cause is a hole in the eardrum, surgery may be needed.
Medications
For children with chronic bacterial ear infections, liquid antibiotics may be prescribed. The most common antibiotics used are amoxicillin or penicillin. Some research suggests that ear drops containing both an antibiotic and acorticosteroid, which can reduce inflammation, are highly effective for treating chronic ear infections.
Ear drops are typically the first-line treatment for a hole in your eardrum. These ear drops may contain antibiotics.
When to Use Amoxicillin for Ear Infections
Surgeries and Specialist-Driven Procedures
If there is damage to the eardrum or the small bones in the middle ear, surgery may be needed. Surgery to repair a hole in the eardrum is known astympanoplasty.
If the infection has spread to themastoid bone, which sits behind the ear, amastoidectomymay be performed.Since the mastoid bone contains small air pockets, the infection can spread into these pockets and cause the bone to break down. A mastoidectomy removes the infected material from those spaces.
If your chronic ear infection results from recurrent infections in your nose, mouth, or throat, anadenoidectomymay be needed. This procedure removes the adenoids, which are glands above the roof of the mouth, at the back of the nose, that fight infections. When these adenoids become inflamed, they can cause fluid buildup in the ear. Research has shown that adenoidectomies may be the best way to manage chronic ear infections in children.
Ear tube surgeryis another treatment option often used for children with chronic ear infections. The surgery involves placing tubes in the eardrum so that airflow is restored. The added airflow evens out the pressure on both sides of the eardrum so fluid can drain from the ear properly.
Can Adults with Chronic Ear Infections Get Ear Tubes?
Chronic ear infections can lead to complications if left untreated, which can include:
Preventing Ear, Nose, and Throat Disorders
Summary
A Word From Verywell
Having a chronic ear infection can be difficult to cope with, especially if you have tried several treatment options and have yet to find relief. The good news is that as soon as you find the right treatment, you will be able to clear up the infection and prevent any further complications or permanent damage.
If you are at risk of developing chronic ear infections or have had an ear infection recently, the best thing you can do is keep an eye on any symptoms. If symptoms continue or get worse, or if the infection returns, get treatment promptly. To help prevent an ear infection from occurring, clean your ears properly using a cloth and wash your hands regularly to avoid coming into contact with bacteria, fungi, or viruses that can cause infection.
Frequently Asked QuestionsThere is no one reason why an ear infection keeps returning. Some common causes of a recurring ear infection include allergies, chronic sinus infections, a blocked eustachian tube, and frequent infections in the nose, mouth, or throat.Treatment options vary depending on the cause of the chronic ear infection. In many cases, ear drops containing antibiotics will be used if the cause is bacterial. If the cause is a hole in the eardrum, surgery like tympanoplasty may be required to repair the damage.Although ear infections aren’t typically a sign of an underlying health condition, they could indicate that there is another infection or there is structural damage to your ear tubes. If you experience any signs of an ear infection, you should see a doctor as soon as possible. Getting treatment early will help prevent permanent damage to your ear or other health complications.Chronic ear infections can cause permanent damage if left untreated. The infection could spread to other parts of the head or cause the eardrum to rupture. Sometimes if a chronic ear infection is left untreated for a long period of time, permanent hearing loss can occur.
There is no one reason why an ear infection keeps returning. Some common causes of a recurring ear infection include allergies, chronic sinus infections, a blocked eustachian tube, and frequent infections in the nose, mouth, or throat.
Treatment options vary depending on the cause of the chronic ear infection. In many cases, ear drops containing antibiotics will be used if the cause is bacterial. If the cause is a hole in the eardrum, surgery like tympanoplasty may be required to repair the damage.
Although ear infections aren’t typically a sign of an underlying health condition, they could indicate that there is another infection or there is structural damage to your ear tubes. If you experience any signs of an ear infection, you should see a doctor as soon as possible. Getting treatment early will help prevent permanent damage to your ear or other health complications.
Chronic ear infections can cause permanent damage if left untreated. The infection could spread to other parts of the head or cause the eardrum to rupture. Sometimes if a chronic ear infection is left untreated for a long period of time, permanent hearing loss can occur.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Ear infection - Chronic.Morris P.Chronic suppurative otitis media.BMJ Clin Evid.0507.Morris P.Chronic suppurative otitis media.BMJ Clin Evid. 0507.Walker RE, Bartley J, Flint D, Thompson JM, Mitchell EA.Determinants of chronic otitis media with effusion in preschool children: a case-control study.BMC Pediatr.2017 Jan 6;17(1):4. doi:10.1186/s12887-016-0767-7Venekamp RP, Damoiseaux RA, Schilder AG.Acute otitis media in children.BMJ Clin Evid.2014:0301.Karunanayake CP, Albritton W, Rennie DC, Lawson JA, McCallum L, Gardipy PJ, Seeseequasis J, Naytowhow A, Hagel L, McMullin K, Ramsden V, Abonyi S, Episkenew JA, Dosman JA, Pahwa P, Project Research Team TF, Study Team TS.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr.2016;2016:1523897. doi:10.1155/2016/1523897Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep.2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media.J Med Microbiol.2015 Oct;64(10):1103-1116. doi:10.1099/jmm.0.000155Boonacker CW, Rovers MM, Browning GG, Hoes AW, Schilder AG, Burton MJ.Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis.Health Technol Assess.2014 Jan;18(5):1-118. doi:10.3310/hta18050Dongol K, Rayamajhi P, Gurung U.Complications of Acute and Chronic Otitis Media in a Tertiary Referral Center in Nepal.Turk Arch Otorhinolaryngol.2020 Dec;58(4):234-240. doi:10.5152/tao.2020.5761Additional ReadingMedline Plus.Ear Infection - Chronic.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Ear infection - Chronic.Morris P.Chronic suppurative otitis media.BMJ Clin Evid.0507.Morris P.Chronic suppurative otitis media.BMJ Clin Evid. 0507.Walker RE, Bartley J, Flint D, Thompson JM, Mitchell EA.Determinants of chronic otitis media with effusion in preschool children: a case-control study.BMC Pediatr.2017 Jan 6;17(1):4. doi:10.1186/s12887-016-0767-7Venekamp RP, Damoiseaux RA, Schilder AG.Acute otitis media in children.BMJ Clin Evid.2014:0301.Karunanayake CP, Albritton W, Rennie DC, Lawson JA, McCallum L, Gardipy PJ, Seeseequasis J, Naytowhow A, Hagel L, McMullin K, Ramsden V, Abonyi S, Episkenew JA, Dosman JA, Pahwa P, Project Research Team TF, Study Team TS.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr.2016;2016:1523897. doi:10.1155/2016/1523897Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep.2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media.J Med Microbiol.2015 Oct;64(10):1103-1116. doi:10.1099/jmm.0.000155Boonacker CW, Rovers MM, Browning GG, Hoes AW, Schilder AG, Burton MJ.Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis.Health Technol Assess.2014 Jan;18(5):1-118. doi:10.3310/hta18050Dongol K, Rayamajhi P, Gurung U.Complications of Acute and Chronic Otitis Media in a Tertiary Referral Center in Nepal.Turk Arch Otorhinolaryngol.2020 Dec;58(4):234-240. doi:10.5152/tao.2020.5761Additional ReadingMedline Plus.Ear Infection - Chronic.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Ear infection - Chronic.Morris P.Chronic suppurative otitis media.BMJ Clin Evid.0507.Morris P.Chronic suppurative otitis media.BMJ Clin Evid. 0507.Walker RE, Bartley J, Flint D, Thompson JM, Mitchell EA.Determinants of chronic otitis media with effusion in preschool children: a case-control study.BMC Pediatr.2017 Jan 6;17(1):4. doi:10.1186/s12887-016-0767-7Venekamp RP, Damoiseaux RA, Schilder AG.Acute otitis media in children.BMJ Clin Evid.2014:0301.Karunanayake CP, Albritton W, Rennie DC, Lawson JA, McCallum L, Gardipy PJ, Seeseequasis J, Naytowhow A, Hagel L, McMullin K, Ramsden V, Abonyi S, Episkenew JA, Dosman JA, Pahwa P, Project Research Team TF, Study Team TS.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr.2016;2016:1523897. doi:10.1155/2016/1523897Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep.2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media.J Med Microbiol.2015 Oct;64(10):1103-1116. doi:10.1099/jmm.0.000155Boonacker CW, Rovers MM, Browning GG, Hoes AW, Schilder AG, Burton MJ.Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis.Health Technol Assess.2014 Jan;18(5):1-118. doi:10.3310/hta18050Dongol K, Rayamajhi P, Gurung U.Complications of Acute and Chronic Otitis Media in a Tertiary Referral Center in Nepal.Turk Arch Otorhinolaryngol.2020 Dec;58(4):234-240. doi:10.5152/tao.2020.5761
MedlinePlus.Ear infection - Chronic.
Morris P.Chronic suppurative otitis media.BMJ Clin Evid.0507.
Morris P.Chronic suppurative otitis media.BMJ Clin Evid. 0507.
Walker RE, Bartley J, Flint D, Thompson JM, Mitchell EA.Determinants of chronic otitis media with effusion in preschool children: a case-control study.BMC Pediatr.2017 Jan 6;17(1):4. doi:10.1186/s12887-016-0767-7
Venekamp RP, Damoiseaux RA, Schilder AG.Acute otitis media in children.BMJ Clin Evid.2014:0301.
Karunanayake CP, Albritton W, Rennie DC, Lawson JA, McCallum L, Gardipy PJ, Seeseequasis J, Naytowhow A, Hagel L, McMullin K, Ramsden V, Abonyi S, Episkenew JA, Dosman JA, Pahwa P, Project Research Team TF, Study Team TS.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr.2016;2016:1523897. doi:10.1155/2016/1523897
Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep.2017;5(2):93-100. doi:10.1007/s40136-017-0151-7
Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media.J Med Microbiol.2015 Oct;64(10):1103-1116. doi:10.1099/jmm.0.000155
Boonacker CW, Rovers MM, Browning GG, Hoes AW, Schilder AG, Burton MJ.Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis.Health Technol Assess.2014 Jan;18(5):1-118. doi:10.3310/hta18050
Dongol K, Rayamajhi P, Gurung U.Complications of Acute and Chronic Otitis Media in a Tertiary Referral Center in Nepal.Turk Arch Otorhinolaryngol.2020 Dec;58(4):234-240. doi:10.5152/tao.2020.5761
Medline Plus.Ear Infection - Chronic.
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