Silverstein Institute
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Surgical Procedures to Treat Chronic Middle Ear Infections

Written by Silverstein Institute
Published: 08 Sep 2020

One reason an ear infection, of any type, requires proper medical attention is the damage that can occur when left untreated. Ear infections, especially those of the middle ear, can be destructive, resulting in loss of hearing. Surgical intervention is necessary to treat the damage from chronic middle ear infections.

Related Blog: The Silverstein Microwick: What is it and How Does it Work

Chronic Middle Ear Infections (Chronic Otitis Media)

The middle ear is home to the eardrum and the eustachian tube. Beyond the eardrum are 3 tiny bones for hearing. The eustachian tube is responsible for equalizing the pressure within the middle ear.

Eardrum Perforation

One condition that requires surgical intervention is a perforation in the eardrum, caused by frequent ear infections. A perforated eardrum usually is accompanied with recurring drainage, and patients may also experience a hearing loss.


Another condition, cholesteatoma, refers to a cyst that forms in the middle ear. If allowed to grow, this cystic formation can be destructive, destroying the tiny bones of hearing, the eardrum, other structures within the ear, facial nerve, and more. Hearing loss is the result of a destructive cholesteatoma.  

Surgical Procedures to Repair Damage from Chronic Otitis Media

We use a publication of the Clinical Symposia to show graphic explanations of the procedures we use to repair the damage from chronic middle ear infections, making it easier to understand these necessary surgical interventions. Both procedures require the patient to be under general anesthesia.

Eardrum Perforation Surgical Repair

Surgical intervention is necessary to clean out infection and repair the eardrum.  

  1. An incision is made behind the ear to expose the perforation. 
  2. In order to make a thorough, microscopic examination of the infection, it is usually necessary to enlarge the ear canal with a special drill. 
  3. Fascia is taken from muscular tissue to reconstruct the eardrum. Part of the tissue will go underneath the eardrum perforation, and the other part covers the area. 
  4. Packing is put in place and is there for up to two weeks. 

Surgical Excision of a Cholesteatoma and Repair

Many times, patients with a cholesteatoma also have a hole in the eardrum with more extensive damage. The main problem of the cholesteatoma is the inside, not the outside. Upon opening this cystic formation, the destruction is evident, usually involving the mastoid bone, and many times the tiny bones of hearing.

  1. Using a drill, we expose the mastoid area to remove this tissue cyst.
  2. When the incus bone, the second bone of hearing, is missing, we use a prosthesis to replace this vital component of the middle ear.
  3. If there is eardrum damage, the reconstructive repair uses temporal fascia.
  4. Repair to the drilled entryway in the mastoid wall is the next repair, using cartilage.
  5. Another bone of hearing, the stapes bone, may also be missing and requires a prosthesis placement.
  6. A tissue flap covers the area.
  7. Packing is put in place and is there for a couple of weeks.

Post-Op Expectations and Follow-up

After surgical procedures, it is critical to follow the post-operative directions for the best possible healing outcomes. After surgical treatment for middle ear infection damage, patients require follow-up for a period to make sure there are no complications, additional infection, or recurrence. At times, a cholesteatoma can recur, requiring further surgical intervention.

Prevention is the Best Medicine

As annual checkups are necessary for a physician to know when you present with a new problem, getting proper medical care is vital to avoid the severe damage, pain, and possible hearing loss from chronic middle ear infections. Hearing loss can affect your joy of life, affecting brain health, and leaving you feeling disconnected and isolated.

The team at the Silverstein Institute, with locations in Sarasota, Venice, and Lakewood Ranch, are highly specialized in the treatment of ear infections and the problems they cause when left untreated, resulting in hearing loss. We are here to help you keep the joy of hearing.

CLICK HERE TO LISTEN TO OUR PODCAST: - Hearing Loss Treatments and Prevention -


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