In this article, we look at the different types of ear infections and what makes them chronic. We also discuss the ways to treat and prevent a chronic ear infection.
Chronic ear infections
Viruses cause most ear infections, although sometimes bacteria are the culprit. There are three main types of ear infections that affect the middle ear:
- Acute otitis media (AOM) is the most common type of ear infection. Fluid builds up behind the eardrum, causing a painful earache.
- Otitis media with effusion (OME) usually occurs in children. It develops after an original ear infection has resolved, but fluid remains trapped in the middle ear. A child may not have any symptoms, but a doctor can see signs of fluid behind their eardrum.
- Chronic otitis media with effusion (COME) is when fluid stays in the ear for an extended period or keeps coming back. Someone with COME often finds it harder to fight off new ear infections and may have some trouble hearing. A doctor will diagnose COME after a person has had OME for 3 or more months.
Another form of chronic ear infection is called chronic suppurative otitis media (CSOM). People with CSOM have recurring and persistent ear discharge. The condition usually develops as a complication of AOM with perforation of the eardrum in childhood.
People with untreated or chronic ear infections can develop several complications. Repeated ear inflammation can cause the following conditions:
- Mastoiditis, which is an uncommon condition that causes AOM symptoms as well as redness or swelling behind the ear.
- Cholesteatoma, which is a growth of skin cells in the middle ear, often due to recurrent ear infections.
Chronic ear infections develop from a long-lasting or recurrent acute ear infection. Preventing acute ear infections can help prevent chronic ear infection.
Acute ear infections happen when the eustachian tube, a tube that runs from the middle ear to the back of the throat, becomes clogged.
Children are more likely to be affected by ear infections because these tubes are shorter and narrower, so they become clogged more easily.
Fluid build-up in the middle ear can become infected, which will cause pain and other symptoms.
Causes of ear infections include:
- bacterial infection
- the common cold
- the flu
Risk factors for chronic ear infections include:
- a recent upper respiratory tract infection
- Down syndrome
- having a cleft palate
- a family history of ear infections
Busy day-care centers can also increase the risk of children developing ear infections, as they come into more contact with viruses and bacteria.
The following tips may help prevent relapses of chronic ear infections:
- Stay away from cigarette smoke. Smoke and secondhand smoke can irritate the eustachian tube. This increases the number and duration of ear infections.
- Avoid using cotton swabs or Q-tips. Putting any object into the ear, particularly the ear canal, can damage the sensitive structures in the ear and increase the chance of injury, disrupt the ear’s natural cleansing mechanism, and push earwax further into the ear canal.
- Wash your hands regularly. Avoiding contact with bacteria and viruses will help the body stay healthy and avoid ear infections.
Outlook
Different types of chronic ear infections require different treatments. Many resolve without treatment.
The American Academy of Otolaryngology recommend watchful waiting to delay prescribing antibiotics for chronic ear infections that are caused by bacteria. However, doctors may prescribe them for some acute ear infections
Always consult a doctor when experiencing symptoms of an ear infection. Be sure to make another visit if an ear infection gets worse, lasts more than 3 days, or symptoms change.
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