Ear Infection (cont.)

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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 infection. If a tympanic membrane perforation is also present, topical antibiotic drops may be used. If eardrum or ossicle scarring has occurred, that will not be reversed with antibiotics alone. Surgery is often 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?

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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 a 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 7/11/2014

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