Treatment for chronic middle ear disease

Most acute middle ear infections (such as otitis media) clear up on their own within a few days and don't require any specific treatment. However chronic middle ear disease may require treatment. You may first be prescribed antibiotics if the infection is caused by bacteria. These may need to be taken over a relatively long period. If the eardrum is perforated (i.e. there is a hole in it), antibiotic ear drops may be used. 

For more complicated conditions, surgery may be recommended to provide a positive long-term solution. Surgical options include: 

• Repairing the eardrum
• Inserting an ear tube
• Removing infection from the mastoid bone (mastoidectomy)
• Repairing or replacing the small bones in the middle ear

Surgery will normally be carried out under a general anaesthetic so you’ll be asleep during the procedure. During the operation the surgeon will be using very small, precision instruments while looking at the area through a microscope.

Depending on the exact nature of the condition, different operations will be required.

During a myringotomy a tiny incision is made in the eardrum (tympanic membrane) to relieve pressure caused by an excessive build-up of fluid, or to drain pus from the middle ear.

A myringoplasty is the closure of a hole (perforation) in the eardrum. When a myringoplasty is combined with a reconstruction of the small bones of the ear, the procedure is called a tympanoplasty. If a hole in the eardrum needs to be repaired, the surgeon may use a piece of your own tissue from near the ear.

If the bones in your ear need replacing or repairing (ossiculoplasty), the surgeon will either use a synthetic bone or sometimes part of your own bone. If infection of the mastoid (the air cavity behind the middle ear) is suspected then the surgeon may also examine this area.

To get a good view and to access your eardrum the surgeon may need to make a cut either behind or in front of the ear.

If you’ve had a general anaesthetic, you won’t be able to drive for 24 hours after surgery. There may be some pain after the anaesthetic wears off and we’ll help relieve this with painkillers. Before you go home we’ll discuss any aftercare requirements or follow-up appointments with you.