What is Chronic (Persistent) Otitis Media?
Chronic (persistent) otitis media is an inflammation of the middle ear cavity behind the eardrum. When acute otitis media is untreated or inadequately treated, it can become chronic, leading to persistent inflammation in the middle ear and surrounding tissues. This chronic inflammation can cause perforation of the eardrum and damage to the ossicles of the middle ear (malleus, incus, stapes).
What is Cholesteatomatous Chronic (Persistent) Otitis Media, and What Can It Lead To?
Cholesteatoma is a type of chronic (persistent) otitis media that occurs when the eardrum collapses into the middle ear cavity, forming a pocket. As the cholesteatoma grows, it damages surrounding tissues. It can erode the ossicles, leading to hearing loss, and may affect the inner ear, causing dizziness and, rarely, serious problems such as facial paralysis. Due to the close proximity of the middle ear to the brain, brain-related complications such as brain abscess or meningitis can also occur, although very rarely.
What are the Symptoms and Signs of Chronic (Persistent) Otitis Media?
The most common symptoms of chronic (persistent) otitis media include ear discharge, hearing loss, and dizziness. During examination, a perforation and retraction of the eardrum, as well as inflammation in the middle ear and external ear canal, can be observed.
How is the Diagnosis of Chronic (Persistent) Otitis Media Made?
The diagnosis of chronic (persistent) otitis media is made through an ear, nose, and throat examination. Hearing tests and computerized tomography of the ear region are used for evaluation.
What is the Treatment for Chronic (Persistent) Otitis Media?
Chronic (persistent) otitis media can be dangerous and should never be neglected. The treatment for chronic (persistent) otitis media is surgical. If there is active ear discharge, antibiotics and ear drops are used before surgery. Patients are advised to prevent water from coming into contact with their ears using Vaseline-soaked cotton or earplugs. In cases of cholesteatoma-associated chronic (persistent) otitis media, the discharge may not respond to medication.
How is Surgery for Chronic (Persistent) Otitis Media Performed?
Surgery on the eardrum is called “Tympanoplasty/ Mastoidectomy” and is performed under general anesthesia. The surgery for chronic otitis media is typically done using a new approach via the external ear canal, without any external incisions. This technique is known as “endoscopic tympanoplasty.” In patients with extensive cholesteatoma, a microscope may be used in addition to the camera. The main goal of the surgery is to clean the chronic otitis media and any cholesteatoma present, achieving a dry middle ear free of inflammation. Various techniques are applied during the surgery to restore hearing.
What Should be Considered in the Postoperative Period of Chronic (Persistent) Otitis Media?
Patients can usually be discharged from the hospital on the first day after the surgery with their dressings in place. Several ear dressings are done after surgery. The status of hearing is measured with hearing tests conducted in the following days. The success rate of the surgery is quite high; however, the risks of complications existing in chronic otitis media can still occur during the surgery, albeit less frequently.
