Chronic Middle Ear Infection: Causes, Symptoms, and Treatment
A chronic middle ear infection develops when repeated ear infections damage the eardrum or lead to the formation of a cholesteatoma, a growth that encourages ongoing infection. Unlike acute ear infections, chronic infections tend to persist or repeatedly flare up over time.
This condition is particularly concerning in children, as untreated infections can lead to hearing loss, speech delays, and serious complications. Understanding the warning signs and knowing when to seek medical care is an important part of first aid awareness for parents, caregivers, and educators across Canada.
Possible Causes of Chronic Middle Ear Infection
Chronic middle ear infections may develop due to:
-
Recurrent acute ear infections
-
Eardrum damage from crushing or penetrating injuries
-
Blockage of the Eustachian tube
-
Blast injuries or chemical burns
-
Structural facial differences such as cleft palate or Down syndrome
In children with a perforated eardrum, infections may also occur when:
-
Water enters the middle ear during bathing or swimming
-
Upper respiratory infections such as colds or sore throats spread to the ear
Flare-ups often cause painless drainage from the ear. The discharge may be thick and have a strong, foul odour, which is a key warning sign for caregivers.
Possible Complications
Without proper medical treatment, chronic middle ear infections can result in:
Polyps
-
Non-cancerous growths that extend from the middle ear into the ear canal
Persistent Infection
-
Damage to the tiny bones of the middle ear (ossicles)
-
Reduced sound transmission and hearing loss
Cholesteatoma
-
A buildup of skin-like material in the middle ear
-
Can erode nearby bone and soft tissue
-
May lead to serious complications such as:
-
Facial nerve paralysis
-
Brain abscess
-
Balance problems
-
Signs and Symptoms
Children with chronic middle ear infection may experience:
-
Ongoing hearing loss
-
Persistent or recurring ear drainage
-
Minimal or no pain unless complications arise
In cases involving a cholesteatoma, white debris may be visible in the ear canal.
How Chronic Middle Ear Infections Are Diagnosed
A healthcare provider can usually diagnose the condition through:
-
Visual examination of the ear
-
Collection of ear discharge for laboratory testing
If complications are suspected, imaging tests such as CT scans or MRI may be used to assess internal damage.
Management and Treatment
Treatment depends on severity and underlying cause and may include:
-
Careful cleaning of debris from the ear by a healthcare professional
-
Ear irrigation using a prescribed solution
-
Antibiotic and corticosteroid ear drops (usually for 10–14 days)
-
Oral antibiotics for more serious infections
If infections persist or recur:
-
Myringotomy with insertion of ventilation tubes may be performed
-
Surgical repair of the eardrum may be required
-
Cholesteatoma must be surgically removed to prevent complications
Why This Matters for First Aid & Safety Awareness in Canada
Chronic ear infections may seem minor at first but can lead to long-term hearing impairment and neurological complications if ignored. For parents, childcare providers, teachers, and first aiders, recognizing abnormal ear drainage and hearing changes is critical.
First aid and CPR training helps Canadians:
-
Identify red-flag symptoms early
-
Support children safely while awaiting professional care
Important Disclaimer
Educational Use Only
This information is intended for general education and first aid awareness and does not replace professional medical diagnosis or treatment. Any child or adult with persistent ear drainage, hearing loss, or signs of infection should be assessed by a qualified healthcare provider. Emergency care is required if neurological symptoms, facial weakness, or severe complications are suspected.