Treatment:

The health care provider may prescribe antibiotics if the infection may be due to bacteria. You may need to take antibiotics for a long time, either by mouth or into a vein (intravenously).

If there is a hole in the eardrum, antibiotic ear drops are used. For a difficult-to-treat infected ear that has a hole (perforation), a dilute acidic solution (such as distilled vinegar and water) may be recommended by your health care provider.

A surgeon may need to clean out (debride) tissue that has gathered inside the ear.

Other surgeries that may be needed include:

• Surgery to clean the infection out of the mastoid bone (mastoidectomy)
• Surgery to repair or replace the small bones in the middle ear
• Repair of the eardrum
• Ear tube surgery

Expectations (prognosis):

Chronic ear infections usually respond to treatment. However, your child may need to keep taking medicines for several months.

Chronic ear infections are not life threatening, but they can be uncomfortable and may result in hearing loss and other serious complications.

Complications:

A chronic ear infection may cause permanent changes to the ear and nearby bones, including:

• Infection of the mastoid bone behind the ear (mastoiditis)
• Ongoing drainage from a hole in the eardrum that does not heal, or after the ear tubes are inserted
• Cyst in the middle ear (cholesteatoma)
• Hardening of the tissue in the middle ear (tympanosclerosis)
• Damage to, or wearing away of the bones of the middle ear, which help with hearing
• Paralysis of the face
• Inflammation around the brain (epidural abscess) or in the brain
• Damage to the part of the ear that helps with balance

Partial or complete hearing loss due to damage of the middle ear may lead to:

• Slow development of language or speech (more common if both ears are affected)

Permanent hearing loss is rare, but the risk increases with the number and length of infections.

Calling your health care provider:

Call for an appointment with your health care provider if:

• You or your child has signs of a chronic ear infection
• An ear infection does not respond to treatment
• New symptoms develop during or after treatment