Chronic Ear Infections

Middle ear infections are common in children and often resolve on their own or with antibiotics. However, when they occur frequently, more aggressive treatment may be recommended to ensure the infection does not damage your child’s eardrum. Duke’s pediatric otolaryngologists are specialists in treating disorders that affect the ear, nose, and throat. They identify the cause of your child’s chronic ear infections and recommend effective treatment to clear the infection, restore temporarily lost hearing, and prevent future illness.

What Causes Chronic Ear Infections

Children may experience frequent ear infections because the insides of their ears are not fully developed. Normally, a child’s Eustachian tubes -- which run from the middle ear to the back of the throat -- drain secretions from the middle ear and serve to keep the pressure behind the ear drum (middle ear) equal to that of the outer ear. Young children have short, straight Eustachian tubes, which can prevent proper pressure equalization. Swelling or inflammation from a cold or allergy can also block the tubes and cause a buildup of fluid in the middle ear. This fluid can become infected with bacteria or a virus.

Untreated chronic ear infections can lead to several complications, including:

  • Cholesteatoma. In severe cases, a skin cyst (cholesteatoma) may develop in the middle ear. The cyst can cause problems with hearing and excessive ear drainage.
  • Tympanic membrane perforation. The eardrum may tear from repeated infections. The hole sometimes closes on its own but may need surgical repair if it does not.
  • Hearing loss. While hearing loss associated with chronic ear infections is rarely permanent, it can occur when an untreated infection results in damage to the eardrum, the bones of the ear, or the hearing nerve.


When necessary, our ENT doctors will work with other pediatric specialists to provide the most appropriate treatment. These specialists may include audiologists, speech pathologists, infectious disease specialists, and allergists.


Our pediatric otolaryngologists typically diagnose chronic ear infections based on your child’s symptoms -- ear pain, fever, irritability, temporary hearing loss, and clogged feelings in the ears -- and by looking at the eardrum using an otoscope. This lighted instrument lets the doctor see the eardrum. A red, inflamed eardrum with fluid behind it usually signals an infection is present. Other tests used to check for middle ear infections include:

Ready for an appointment?
- call us at -