Chronic Otitis Media: A Long-Lasting Ear Infection
Chronic otitis media is a condition caused by infections that persist over a long period and flare up occasionally. This infection occurs in the middle part of the ear, in a small space behind the eardrum. This area is where sound waves are transmitted to the hearing mechanisms. Unlike acute otitis media, chronic inflammation can last for weeks or even months and often arises as a result of ear problems that begin in childhood. In chronic otitis media, a hole may be visible in the eardrum, and inflamed tissue or cholesteatoma may be present behind this hole.
What is Cholesteatoma?
Cholesteatoma is a serious complication seen in some forms of chronic otitis media. It is not a tumor or cancer but an abnormally growing skin tissue. Cholesteatoma can develop on the eardrum, in the middle ear, or in the mastoid bone behind the ear. Over time, this tissue grows and can damage small bones in the ear, such as the malleus, incus, and stapes, leading to hearing loss. In more advanced cases, cholesteatoma can affect surrounding tissues, leading to deafness, balance problems, rarely facial paralysis, and meningitis (inflammation of the brain membranes), which can cause serious issues.
What Are the Symptoms?
The symptoms of chronic otitis media and cholesteatoma typically include:
- Persistent ear discharge (usually a foul-smelling fluid).
- Hearing loss.
- Feeling of fullness or pressure in the ear.
- Dizziness or balance problems (in rare cases).
- Severe cases may present with ear pain or facial muscle paralysis.
What Causes It?
Chronic otitis media is usually caused by untreated or recurrent infections. In particular, untreated adenoid growths in childhood and related upper respiratory infections can cause chronic dysfunction of the Eustachian tube. This leads to poor ventilation of the middle ear, which results in the chronic nature of the infections. Cholesteatoma usually develops as a result of a poorly healed eardrum or pressure problems within the middle ear. The vacuum effect in the middle ear can cause skin cells to grow in the wrong places.
Treatment Methods
Chronic otitis media can be managed during flare-ups with antibiotics or ear drops. However, definitive treatment usually requires surgical intervention. During surgery, if cholesteatoma is present, it is removed, damaged structures are repaired, and the eardrum is repaired. If hearing loss is present, hearing may be improved through the repair of the ossicles or the use of prosthetics. The main goal of surgery is to achieve a clean and healthy ear free of infection.
Can It Be Prevented?
Early diagnosis and regular ear care are crucial in preventing such problems. Conditions like adenoid growth and ear infections in childhood should be taken seriously and treated on time. Particularly in cases of recurrent middle ear infections, an evaluation by a specialist is necessary.
