Chronic Ear Infection Treatment in Dallas, Frisco and Fort Worth
What is chronic otitis media?
When we get an ear infection, pus fills the space behind the eardrum called the middle ear. In many cases, antibiotics are given, and the infection completely resolves. This is called acute otitis media.
Some patients have inflammation in the middle ear all the time. Antibiotics have little effect in these cases. Over time, changes to the ear drum or hearing bones occur. This is called chronic otitis media.
How does chronic otitis media affect the ear?
Chronic serous otitis media refers to benign fluid behind the eardrum that is present for at least three months. The fluid hinders movement of the ossicles and eardrum causing a conductive hearing loss. Pressure equalization tubes may improve the hearing. Hearing aids can help with hearing loss not improved with tubes.
Perforation of the eardrum is a hole in the eardrum due to chronic otitis media. The hole prevents the eardrum from amplifying sound properly causing a conductive hearing loss. The presence of a hole in the eardrum also results in frequent drainage from the ear. The ear may be extra sensitive to water. The frequency of ear infections may increase. Long standing perforations may enlarge, cause further hearing loss, or even develop cholesteatoma.
Atelectasis of the middle ear is collapse of the eardrum due to chronic otitis media. This can occur with or without serous fluid. It can damage the eardrum and ossicles and may lead to cholesteatoma formation if left untreated. A conductive hearing loss results from the combination of impaired eardrum movement, damaged ossicles, and fluid behind the eardrum.
Cholesteatoma is a growth of infected skin behind the eardrum that occurs with chronic otitis media. It is the most severe manifestation of chronic otitis media. As it grows it destroys the eardrum, hearing bones, and ear canal. If left untreated, it can damage nearby structures including the inner ear, facial nerve, and temporal lobe of the brain.
What are the surgical options for chronic otitis media?
Pressure equalization tubes are tiny stents placed in the eardrum. Placement requires 30 minutes or less of anesthesia in the OR for children. Placement is an office procedure for adults. After tube placement, ear plugs are recommended for swimming underwater. Shower or bath can be done without ear plugs. Tube placement is very safe and results in improved hearing in most cases. Rare complications include drainage from the ear or perforation of the eardrum.
Tympanoplasty refers to reconstruction of the eardrum. This may apply to a perforation or to a defect created by removing cholesteatoma. Repair of the perforated eardrum is performed using the patient’s own tissue as a graft. Cartilage grafting adds a layer of stability to the eardrum reconstruction.
Ossicular reconstruction refers to repairing the hearing bones. This may apply to ear bones damaged by a collapsed eardrum, recurring infections due to perforation, or damage from cholesteatoma. Prostheses are made of various materials. They are available at the time of tympanoplasty and can be done during the same surgery.
These procedures require approximately 1-2 hours under general anesthesia. Patients usually go home the same day, not requiring hospitalization.
In summary, chronic otitis media is an ear disease characterized by poor ventilation of the ear leading to chronic exposure of the middle ear structures to inflammation resulting in various manifestations. A variety of surgical procedures are available to manage these conditions. These procedures are outpatient, relatively short, very common, and safe. Call one of our ENT clinics in Dallas, Frisco or Fort Worth to schedule an appointment.