If the infection in the middle ear cavity continues for more than 3 months, it is called chronic ear infection.
Chronic ear infections and eardrum perforations are generally examined in 3 main sections
dry ears with a hole in the eardrum
runny ears with a hole in the eardrum
ears with cholesteatoma
DRY EARS with a hole in the eardrum
In these patients, the infection in the middle ear subsided. There is no active inflammatory process in the middle ear. However, as a sequela of the infection, the eardrum remained perforated. This hole may be very small, or the entire eardrum may be completely lost. These ears are always at risk of recurrence of infection. When there is an infection, discharge begins in the ear. These patients have a hearing loss of around 20-40 dB due to a perforated eardrum. If there is damage to the ossicles in the middle ear, hearing loss may be greater. Early eardrum perforations may heal and close on their own. However, as the period increases, the chance of closure decreases, and if the period exceeds 3 months, there is no chance of spontaneous closure. In such a case, the eardrum must be repaired with a surgery called tympanoplasty.
DRAINY EARS WITH A HOLE IN THE EARDRAM
In these patients, the eardrum is perforated and There is an active inflammatory process in the middle ear. As a result, there is usually a foul-smelling discharge in the ear. The patient has a conductive hearing loss of 30-60 dB. In these patients, the chance of damage to the ossicular system is higher than in dry ears.
In these patients, the primary aim is to dry the infection with drug treatment. For this purpose, in addition to oral antibiotic use, antibiotic and cortisone drops are applied to the ear. If the infection is eliminated with medication and the ear becomes dry, the hole in the eardrum is then repaired with tympanoplasty surgery. However, if ear discharge does not stop despite drug treatment, surgical treatment must be performed in these patients. Because chronic infection in the middle ear can cause serious problems such as melting of the ossicles, meningitis, brain abscess and permanent hearing loss. In these patients, the infection in the middle ear is cleared and the eardrum is repaired with a method called tympanomastoidectomy.
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EARS WITH CHOLESTEATOMA
The term cholesteatoma is briefly defined as the skin being in the wrong place, that is, in a place where it should not be. Normally, the middle ear cavity is covered by a covering called mucosa. In some cases, this covering is replaced by skin tissue, resulting in a disease called cholesteatoma. Cholesteatoma tissue grows by folding on itself, just like an onion. It causes the surrounding bone tissue to melt and decay due to its pressure effect and some substances it secretes. As the cholesteatoma in the middle ear cavity grows, it first causes the ossicles to melt and then the ear bone to melt. After a while, it can reach outside the ear bone and cause very serious complications such as facial paralysis, abscess formation under the skin, meningitis, brain abscess formation, and damage to the inner ear.
Cholesteatoma is diagnosed by seeing cholesteatoma tissue during ear examination and radiological examinations. is placed. There is no drug treatment for cholesteatoma. The only procedure to be performed is surgical removal of the entire cholesteatoma.
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