CHRONIC EAR INFECTION
Symptoms of chronic ear infections depend upon whether the condition is active or inactive, whether or not there is involvement of the mastoid bone and whether or not there is a hole in the eardrum. There may be discharge, hearing impairment, tinnitus (head noise), dizziness, pain or, rarely, weakness of the face.
Any disease affecting the ear drum or the three small ear bones may cause a conductive hearing loss by interfering with the transmission of sound to the inner ear. Such a hearing impairment may be due to a perforation (hole) in the ear drum, partial or total destruction of one or all of the three little ear bones, or scar tissue.
When an acute infection develops in the middle ear (an abscessed ear), the ear drum may rupture, resulting in a perforation. This perforation usually heals. If it fails to do so a hearing loss occurs, often associated with head noise (tinnitus) and intermittent or constant ear drainage.
Medical treatment frequently will stop ear drainage. Treatment consists of careful cleaning of the ear and, at times, the application of antibiotic powder or ear drops. Antibiotics by mouth may be helpful in certain cases.
For many years surgical treatment was instituted in chronic otitis media primarily to control infection and prevent serious complications. In recent years changes in surgical techniques have made it possible to reconstruct the diseased hearing mechanism in most cases.
Various tissue grafts may be used to replace or repair the ear drum. These include skin from the ear canal, covering of muscle from above the ear (fascia), and covering of ear cartilage (perichondrium). A diseased ear bone may be repositioned (relocated) or replaced by a prosthetic (artificial material). Cartilage is frequently used to substitute for a missing ear bone.
Dissolvable material frequently is used behind the ear drum to prevent scar tissue from forming and to promote normal function of the middle ear and motion of the ear drum. When the ear is filled with scar tissue, or when all ear bones have been destroyed, it may be necessary to perform the operation in
two stages. The first stage is to allow more normal healing without scar tissue. At the second stage an attempt to restore hearing is made.