Middle Ear Infection or Inflammation (Otitis Media)

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Author: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideEar Infection Symptoms, Causes, and Treatment

Ear Infection Symptoms, Causes, and Treatment

What happens to the eardrum if a hole develops in the eardrum?

A hole that forms in the eardrum (tympanic membrane perforation) usually causes a chronic draining ear, or a condition called chronic otitis media with perforation. Often the drainage (otorrhea) will have a foul odor and can be seen draining from the ear. Hearing can improve after the middle ear fluid is released, or it may worsen secondary to the inflammation in the middle ear.

How is chronic middle ear infection or inflammation treated?

Initially, antibiotics may resolve the ear infection. If a tympanic membrane perforation also is present, topical antibiotic drops may be used. If eardrum or ossicle scarring has occurred, that will not be reversed with antibiotics alone. Surgery often is indicated to repair the tympanic membrane (eardrum), remove the infected tissue and scar from the middle ear and the mastoid bone. Long-term prophylactic antibiotics are not recommended.

What are the goals of chronic otitis media surgery?

The goals of surgery are to first remove all of the infected tissue so that it can be "safe" from recurrent infections. The second goal is to recreate a middle ear space with an intact eardrum. Finally, hearing is to be restored. This may seem strange that hearing is the last priority, but if the first two priorities are not met, anything that is done to improve hearing will ultimately fail. If hearing is restored, but the infection returns, the hearing will be lost again. Likewise, if hearing is restored, but the middle ear space is not recreated, the eardrum will re-stick to the middle ear or the ossicles.

What is serious middle ear infection or inflammation?

Serous otitis media is inflammation in the middle ear without infection. Typically, the Eustachian tube is not functioning and cannot ventilate the ear normally. As a result, fluid accumulates in the middle-ear. This can lead to a dullness or fullness within the ear along with diminished hearing.

Medically Reviewed by a Doctor on 8/3/2016

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