A chronic infection of the middle ear is far more serious than an acute infection. An acute infection flares up suddenly and often painfully, but usually causes little damage. A chronic infection is slow, relentless, and can cause permanent damage. Chronic infection of the middle ear is often the result of an untreated ear infection in childhood. The infection either never completely clears up, so that some of the organisms that caused it remain in the ear, or it eventually clears up but leaves a site that is particularly susceptible to subsequent infection. Pus produced continually from the chronic infection eventually causes a hole to form in the eardrum, and often damages or destroys the small bones of the middle ear.Cholesteatoma is another form of the disorder. It is potentially more dangerous, because it can lead to paralysis of the face or even to fatal brain infection in the worst cases.

What are the Symptoms?

Grayish or yellowish pus will seep from the ear periodically. You may have some amount of hearing loss, depending on how long the infection has been present.

What are the Risks?

If the infection reaches an advanced stage, it may spread to a portion of the bone behind the ear called the mastoid process. If this occurs, you may need to have an operation called a mastoidectomy. In the rare cases of unsuccessful treatment, the bones of the ear may become damaged. This can cause permanent deafness.

What Should be Done?

If the infection is viral, the risks are minimal. If the infection is bacterial, and if treatment is delayed too long, there is a danger that the problem may become chronic, or that the infection may spread to a portion of the bone behind the ear called the mastoid process. If it does spread to the mastoid process, an operation that is known as a mastoidectomy may become necessary. In this relatively simple operation, an incision is made behind the ear and the infected bone is removed.

See your physician, who will probably examine your ears with an otoscope and arrange for X-rays of your head to find out if the infection has spread to the mastoid area. Only then can the doctor determine if you need a mastoidectomy.

What is the Treatment?

Self-help: Keep the ear dry and clean. Wipe away any discharge with a cotton swab.

Professional help: The physician will probably clean the ear and may prescribe an antibiotic in tablet form and ear drops containing an antibiotic. This treatment is aimed at eliminating the infection, drying up the ear, and preventing any discharge for a period of three months.