Chronic Otitis Media: Managing Persistent Ear Fluid After Ruptured Eardrum

Q: Chronic Otitis Media: Managing Persistent Ear Fluid After Ruptured Eardrum

Hello： Generally, simple serous otitis media is primarily manifested by a feeling of ear fullness, and it rarely presents with ear discharge or secretions. <br>If there is recurrent fluid drainage from the ear, it is often associated with bacterial infection, and prolonged durati

Otitis media with effusion

Nineteen years ago, I accidentally perforated my eardrum but was unaware at the time and rinsed it with water.
Subsequently, I began to notice yellow-green fluid.
Since I was living abroad, I only managed to wipe away the fluid until the end of the year when I returned to Taiwan for an examination, where I discovered the eardrum was ruptured and there was fluid accumulation.
The doctor suctioned the fluid from my ear and advised me not to get it wet for two to three months.
However, after leaving Taiwan, fluid began to accumulate again even without exposure to water.
In 2020, I visited a clinic in Malaysia (early in the year) and a hospital (at the end of the year), but I still experienced fluid accumulation, which had become thicker.
I researched information from Chang Gung Memorial Hospital, Tri-Service General Hospital, and National Taiwan University Hospital, and most of the characteristics align with effusive otitis media.
Some sources also mention the potential risks of meningitis and permanent perforation.
However, I may not be able to return to Taiwan until late 2021 or early 2022.
Given that this has persisted for almost three years, is there still a possibility for recovery?

J, 10~19 year old female. Ask Date: 2021/02/23

Dr. Zheng Jueyi reply Otolaryngology

Hello: Generally, simple serous otitis media is primarily manifested by a feeling of ear fullness, and it rarely presents with ear discharge or secretions.
If there is recurrent fluid drainage from the ear, it is often associated with bacterial infection, and prolonged duration can lead to long-term hearing loss.
If symptoms persist without improvement, it is recommended to seek medical evaluation and treatment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/02/23

More Info

Chronic otitis media, particularly following a ruptured eardrum, can be a complex condition to manage, especially when it involves persistent fluid accumulation in the middle ear. Your situation, where you experienced a perforated eardrum and subsequent fluid buildup, is not uncommon. The yellow-green fluid you described is indicative of an infection, and the fact that it has persisted for nearly three years raises several concerns.

When the eardrum is ruptured, it can lead to a condition known as otitis media with effusion (OME), where fluid accumulates in the middle ear space. This fluid can become infected, leading to chronic otitis media. The presence of thickened fluid suggests that the infection may have become chronic, which can result in complications if left untreated. Chronic otitis media can lead to further issues, including hearing loss, persistent ear pain, and even more severe complications such as mastoiditis or meningitis if the infection spreads.

Given that you have been experiencing this issue for an extended period, it is crucial to seek specialized care as soon as possible. Here are some steps and considerations for managing your condition:
1. Consult an Ear, Nose, and Throat (ENT) Specialist: Since you have already been diagnosed with a ruptured eardrum and chronic fluid accumulation, it is essential to follow up with an ENT specialist. They can perform a thorough examination, possibly including a tympanometry test to assess the middle ear function and the presence of fluid.

2. Possible Surgical Intervention: If the fluid persists despite conservative management (such as avoiding water exposure and using medications), surgical options may be considered. One common procedure is tympanostomy tube insertion, where small tubes are placed in the eardrum to allow fluid to drain and to ventilate the middle ear. This can help alleviate symptoms and prevent further complications.

3. Regular Monitoring: Since you mentioned that you may not return to Taiwan until late 2021 or early 2022, it is crucial to find a local ENT specialist in Malaysia who can monitor your condition. They can provide interim care and possibly manage the fluid accumulation until you can return for more definitive treatment.

4. Antibiotic Therapy: If there is an active infection, your doctor may prescribe antibiotics to help clear the infection. However, if the fluid is non-infectious, antibiotics may not be necessary.

5. Avoid Water Exposure: As advised by your previous doctor, it is essential to keep the ear dry. Water exposure can exacerbate the condition and lead to further complications.

6. Educate Yourself on Symptoms: Be aware of any new symptoms, such as increased pain, fever, or changes in hearing. These could indicate a worsening infection or complications that require immediate medical attention.

7. Long-Term Outlook: While chronic otitis media can be challenging to manage, many patients see improvement with appropriate treatment. Early intervention is key to preventing long-term complications, including potential hearing loss or more severe infections.

In conclusion, while your situation is concerning, there are treatment options available. It is essential to seek care from an ENT specialist who can provide a tailored approach to your condition. Regular follow-ups and monitoring will be crucial in managing your chronic otitis media effectively.

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