Chronic middle ear infection
Ear is consisted of three parts; outer, middle and inner. Middle ear includes tympanic membrane and three ossicles. Anything effecting them causes conduction type hearing problem. This may be a perforation in the membrane or a problem in the ossicles.
If an infection occurs in the middle ear, tympanic membrane can be perforated and pus may come out. This perforation can heal by itself. If not, hearing loss, persistant or temporary drainage can be seen.
Ear care: If your tympanic membrane is perforated you should avoid water go in your ear canal. While taking a bath or swimming you should close your ear canal with cottons immersed with vaseline.
Prevent strong blowing of your nose. This may cause microbes go from nasopharynx to the middle ear from Eustachian tube.
If there is an ear drainage it can be cleaned with cotton without putting it to much inside the ear canal. It should be treated by drugs.
Medical treatment: Medical treatment mostly stops the drainage. The continuous therapy should be arranged by your doctor.
Surgical treatment: Chronic infections are treated by surgery, aim is to stop drainage and prevent the complications. While doing that hearing is tried to be preserved or reconstructed.
Many materials can be used to close perforation. It is mostly taken from the tissues around the patient’s ear.
Ear drum repair (myringoplasty): Most middle ear infections are self limited, some cause persistent perforation in the membrane.
Repairing the membrane prevents the middle ear and sometimes repair the hearing also. This surgery is done when the middle ear ossicles are intact. Operation can be done through the ear canal or behind the auricle. The last result is reached after six weeks.
Middle ear repair (tympanoplasty): This is done when the ossicles get harm because of infection together with the membrane. Both the membrane and the ossicles are repaired.
Hearing mostly gets better.
In some patients both repair cannot be possible therefore first the membrane is repaired and after 4 months the middle ear ossicles are repaired.
Middle ear operation with tympanic bone included to the surgery (Tympanoplasty with mastoidectomy): Sometimes infection spread sto the tympanic bone which is full of small air cells. This may cause a cyst called “cholesteatoma”. This can erode the bone and can cause serious complications like meningitis, deafness, facial palsy if not treated.
Radical Mastoid Operation (Radical mastoidectomy): Aim of this operation is to get rid of the infection without taking hearing into consideration. This is done in persistant chronic infections.
Mastoid Obliteration: Aim of this operation is to fill the mastoid cavity mostly with muscle or fat tissue to prevent recurrings.