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Chronic Middle Ear Disease
With Tympanic Membrane Perforation
Definition: The middle ear is the air space between the back side of the tympanic membrane, or ear drum, and the bone of the inner ear. This space contains the ossicles, or bones of hearing, and the eustachian tube, and is lined with a mucous membrane. When the eustachian tube functions poorly, or not at all, disease occurs within this space. This may be in the form of fluid accumulation (serous otitis media) and/or infection (otitis media). Sometimes an infection is severe enough to cause the ear drum to rupture and form a hole, or perforation. Most of these perforations close spontaneously, but a small percentage do not and result in chronic middle ear disease in the form of persistent infections with resulting purulent drainage, pain, hearing loss, and occasionally dizziness. This is called chronic middle ear disease with tympanic membrane perforation.
Treatment: These infections very seldom resolve spontaneously and require the use of antibiotics such as ear drops, oral preparations, and intravenous infusions. Untreated infections can result in more serious infections of the mastoid cavity (mastoiditis), intracranial abscesses (brain abscesses), tumors of the middle ear (cholesteatomas), permanent hearing loss, and rarely death. In general, antibiotics are extremely effective in controlling the infections, but occasionally surgical intervention is required.
Prevention: The most common cause of these infections is the presence of water and microorganisms in the ear canal and middle ear. It is impossible to permanently eliminate microorganisms from the ear canal and middle ear so the main emphasis of prevention is the elimination of water. Avoidance of situations that risk getting water in the ear along with the use of ear plugs designed to seal the ear against water are the primary methods of prevention. The regular use of the new Mack's Ear Dryer ear canal drier can remove this undesired water and also help prevent infection. The use of cotton tips, ear drying drops, and shaking the head are ineffective or contraindicated in preventing these infections.
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