If the ear hurts badly in children, it is probably due to an acute middle ear infection. By contrast, chronic - ie permanent - middle ear infections are more likely to plague adults. They differ significantly from the acute form.
"In the chronic form, the mucous membranes of the middle ear are repeatedly and long-lasting inflamed," says Andreas Gerstner, chief physician of the Department of Otolaryngology in Braunschweig. "Besides, there is usually a permanent hole in the eardrum."
How can chronic otitis media be detected?
The problem with chronic otitis media: The painful piercing of the ear, which marks acute inflammation, usually does not occur.
"One indication may be that permanent secretion from the ear," says Jens Peter Klussmann, director and chair holder of the Department of Otolaryngology at the University of Cologne. "Frequently hearing also deteriorates."
Why do doctors recommend surgery?
If the ENT doctor determines chronic otitis media, surgery is often advisable. The hole in the eardrum can be closed, damaged ossicles could be reconstructed, explains the physician.
The surgery is useful even for weak symptoms, "because untreated, chronic middle ear infections worsen hearing and patients can become deaf," explains Gerstner.
In addition, sufferers would have to be very careful in everyday life: "There must be no water in the ear canal." It could penetrate through the hole in the eardrum into the middle ear and trigger acute inflammations there. In addition, the organ of balance is irritated, which can trigger violent vertigo.
Another reason for the treatment: Chronic middle ear inflammation increases the risk of bone suppuration, the so-called cholesteatoma. "Then the inflammation has infested the bone and destroyed it," says Gerstner.
For the patient, this dangerous disease is difficult to detect. "Reference may be a foul-smelling ear secretion." A cholesteatoma must be treated surgically. "If surgery is not performed, facial nerve paralysis, dizziness, or even blood poisoning and meningitis can occur in the course," says Klussmann.
Can you prevent chronic middle ear infection?
Because smoking irritates the mucous membranes, it makes sense in any case not to consume cigarettes.
Overall, however: "Prevention is difficult," says Klussmann. "Some people are more prone to middle ear infections than others, and they probably have a local immune deficiency." In addition, the anatomy of the ear play a role. "Affected suffer from a permanent ventilation disorder."
In that case, however, the pressure compensation can be trained. One method is the so-called Valsalva maneuver, says Gerstner: "Patients hold their noses and breathe out with their mouths closed and tense abdominal muscles as if they are snorting." This leads to a pressure equalization in the ears and helps to ventilate the Eustachian tube.
What do home remedies bring?
Home remedies such as onion bags or cotton wool for the ears to protect against wind and weather are ineffective, according to Klussmann. "I advise against cotton wool." A middle ear infection does not arise from the outside, but from the inside over the nasopharynx. " Cotton in the ear could lead to inflammation of the ear canal.