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Chronic Ear Infection (Chronic Otitis Media)


The Manual's Editorial Staff

Last full review/revision Jul 2020| Content last modified Jul 2020
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Your middle ear is a hollow space behind your eardrum. The middle ear contains 3 tiny bones that transmit your eardrum's vibrations to the nerves in your inner ear.

Inside the Ear

Inside the Ear

What is a chronic ear infection?

Different parts of your ear can get infected, but you're most likely to have an infection in your middle ear. "Media" means middle, and "otitis" means inflamed ear, so doctors call this infection otitis media. It's called acute otitis media when it happens quickly and gets better quickly. Doctors call it "chronic" when it lasts more than 3 months.

  • Having an acute ear infection that doesn't go away can turn into a chronic ear infection

  • Your ear doesn't hurt, but you have thick fluid or pus coming out of your ear

  • You have hearing loss, which can be permanent

  • Doctors clean your ear canal and give you antibiotic eardrops

What causes chronic ear infections?

Usually a chronic ear infection starts with an acute ear infection that:

A chronic ear infection may flare up after:

  • You get a cold

  • Water gets in your middle ear through the eardrum perforation while you're bathing or swimming

Children who have birth defects of their face have an increased risk of chronic ear infections.

What are the symptoms of a chronic ear infection?

The most common symptoms are:

  • Thick fluid or pus coming out of your ear

  • Hearing loss

What are the complications of chronic ear infection?

The hole in the eardrum may let in dangerous bacteria that cause a worse infection. That infection may destroy the tiny bones in your middle ear or spread to nearby skull bones.

Some people with chronic ear infections develop a cholesteatoma in the middle ear. A cholesteatoma is a growth that looks like skin and isn't cancerous. A cholesteatoma increases your risk of having serious complications, including:

  • Hearing loss that doesn't get better

  • Infections in other parts of your ear, the bones of your skull, or your brain

  • Damage to the nerve that controls movements in your face

How can doctors tell if I have a chronic ear infection?

Doctors will do a hearing test and use a handheld light to check in your ear for:

  • Pus (thick fluid)

  • A cholesteatoma (skin-like growth in your middle ear)

If doctors think you have a cholesteatoma, they may do a CT scan or MRI.

How do doctors treat chronic ear infections?

When a chronic ear infection flares up, doctors will:

  • Clean your ear canal and middle ear

  • Give you antibiotic ear drops

  • Give you antibiotics to take by mouth, if needed

If you have a hole in your eardrum, they will tell you to keep water out of your ear.

Doctors may also recommend surgery if you have:

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