October 14, 2022 Chronic otitis media an inflammation of the middle ear that last for more than 3 months . In most cases, chronic otitis media presents with perforation of the eardrum. However, there are other forms with the tympanic membrane intact, retracted or even adhesive to the inner wall of the tympanic cavity. One of the most feared forms of chronic otitis media is cholesteatomatous otitis . Usually, this otitis results from a simple chronic otitis media, but not treated for a long time. Chronic otitis media has a major socioeconomic impact, as it can lead to episodes of infection and hearing loss . Causes of chronic otitis media The causes of chronic otitis media are multiple and complex, but they have factors in common, such as poor ventilation of the middle ear . When there is an exacerbation of the disease and infection appears: Gram-negative microorganisms are most often involved, like Pseudomonas aeruginosa , Escherichia coli and Proteus mirabilis . Infection with Staphylococcus aureus , a common agent of colonization of the external auditory canal (which in these cases is in direct contact with the middle ear due to tympanic perforation) is also common. These infections have a high rate of recurrence and complications if not treated properly and on time, for example: Abscesses; Cellulitis; Parotitis; Labyrinthitis; Facial paralysis; Perilymphatic fistula; Meningitis; Venous thrombosis. Treatment of exacerbations Treatment must include the resolution of infectious episodes and optimization of middle ear ventilation . In some cases, a surgical and more definitive approach may be necessary. The goals of treating these exacerbations are to control the infectious agent, reduce the risk of complications and of long-term functional sequelae, and also prepare the ear for surgical treatment when the situation allows it. When to see an otolaryngologist The main symptoms that should motivate an otolaryngology consultation are: Persistent or intermittent otorrhea (pus coming out of the ear); Hearing Loss . Others, less common, are pain, tinnitus, dizziness or vertigo, and facial paralysis. This article was written by the Hospital da Luz otorhinolaryngology team. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
