There are two main ways to diagnose chronic otitis media. The first is a physical exam, which will find fluid behind the eardrum and poor movement of the eardrum. The second way is to measure the amount of eardrum mobility with a special test. The test is abnormal when fluid is behind the eardrum. A hearing test will often reveal some hearing loss as well.
In chronic middle ear inflammation due to a tear in the eardrum or an ear cyst, the diagnosis is usually made with a physical exam. Hearing tests are usually abnormal in this case as well. Special x-ray tests, such as a CAT scan, may be done in some cases.