The ear is a vital organ that enables constant communication with the outside world. Any damage to the ear can have severe consequences. However, many people unknowingly put their ears at risk by neglecting proper care and exposing them to chronic infections, often realising the issue too late.

The middle ear plays a crucial role in transmitting sound waves from the external environment to the inner ear. However, long-term infection or inflammation of the middle ear can lead to perforation of the tympanic membrane, which is essential for hearing.

Typically, the ear exhibits purulent or mucopurulent discharge, accompanied by dizziness, in cases of chronic ear infections. Bacteria are the primary cause, but other microbes can also be involved. Additionally, respiratory viruses responsible for the common cold can contribute to middle ear infections that persist over time. Furthermore, ear fungal infections are also a possibility.

Chronic ear infections can result in perforation of the middle ear. Common risk factors for these infections include persistent infection and inflammation, using objects like pins or needles to scratch inside the ears, recurrent colds and sneezing, and having water in the ear from activities like showering or swimming.

The issue commences with discomfort that gradually intensifies as pus accumulates behind the ear. As the amount of pus increases, a noticeable discharge of pus becomes evident. This may be accompanied by a headache and a high fever. Enlarged and painful lymph nodes can occur around the ears as a result of infection drainage.

If left untreated, the infection has the potential to spread to the brain and its coverings, leading to severe illness, paralysis, and even coma. Additionally, the microbes can travel to the lungs, causing pneumonia. Through the bloodstream, the infection can become widespread, resulting in septicaemia. Prolonged infection can also cause damage to the ear, leading to deafness. This infection is a significant cause of preventable deafness in young adults.

A person of any age or gender can develop a chronic middle ear infection. Children are more susceptible as they have a short length of tube connecting the throat and middle ear. Bottle feeding done with the toddler in a supine position is another risk factor. Once children develop an ear infection, they are prone to develop complications unless treated adequately.

Pain and swelling behind the ear, as well as pus discharge, indicate a persistent middle ear infection. This can be confirmed by visualising the ear using an otoscope. The specific microbes causing the infection can be identified through microscopic examination and culturing of the pus discharge.

The appropriate use of antibiotics, either in the form of tablets or local ear drops, can effectively heal an infection. However, for chronic and resistant infections, surgical intervention may be necessary.

To prevent chronic ear infections, it is crucial to avoid piercing the ear or inserting anything into it. Additionally, keeping the ears dry is important. When swimming or showering, it is recommended to plug the ears with cotton or use a shower cap. Protecting the ears from drafts of cold or hot air also helps prevent inflammation and infection in the middle ear.

Regularly practicing steam inhalation can be beneficial for alleviating common cold symptoms and preventing internal inflammation and congestion in the ear. It is important to avoid keeping a bottle-fed baby in a supine position with their head flat on the bed, as this can increase the risk of ear infections.

If you experience any itching, pain, or discharge in your ear, it is advisable to seek medical attention and receive appropriate treatment to prevent the development of a chronic infection.

Dr Rachna Pande is a specialist in internal medicine.