How do I Choose the Best Treatment for Chronic Otitis Media?

Otitis media is the inflammation of the middle ear, the area of the ear between the tympanic membrane and inner ear. Chronic otitis media is inflammation that persists for three months or more. Treatment for chronic otitis media depends on the cause and severity of the disease. Generally, chronic otitis media treatments include a thorough evaluation, a regimen of antibiotics or ear drops, rest and avoidance or removal of the cause of the disease. Patients who have severe chronic otitis might need surgically implanted ventilation tubes.

Within the middle ear, fluid normally drains through the eustachian tube into the back of the throat. When the tube is blocked, fluid accumulates and pathogens multiply, causing acute otitis media, also known as an ear infection. Chronic otitis media might be caused by repeated acute otitis media or by ear infections that do not completely heal. In rare cases, chronic otitis media might lead to the development a cyst in the middle ear, mastoiditis, hardening of the tympanic membrane or damage to the delicate bones of the middle ear. Severe, untreated chronic otitis media might cause permanent damage and hearing loss.

Treatment for chronic otitis depends on the cause of the infection and the advancement of the disorder. Common causes of chronic otitis media are allergies that cause the eustachian tube to swell and become blocked; bacteria or viruses, such as Streptococcus pneumoniae or Moraxella catarrhalis, that proliferate in the middle ear; blockage from swollen tonsils or adenoids in the throat; or nutritional deficiencies, found especially in children lacking vitamin A, zinc and iron. A physician thoroughly evaluates the possible cause and administers the most effective otitis media remedy. The most common initial treatment is antibiotics and rest. If chronic otitis is caused by allergies or nutritional deficiency, a wholesome diet and avoidance of allergens is prescribed.

More serious cases of chronic otitis media require more decisive treatments. Antibiotic ear drops or a dilute distilled vinegar solution are common initial treatments for a punctured eardrum. Surgery might be required to debride the ear of infection, to repair the eardrum or small bones in the middle ear or to remove tonsils that interfere with proper tube drainage. Myringotomy is a surgical procedure in which a surgeon makes a small incision in the eardrum and implants a tiny ventilation tube to promote drainage. The tube usually falls out within a year, and additional surgeries might be required.