Why is my ear discharging?

What causes Ear Discharge ?
Most cases , the ear discharges the earwax that might be seen as
discharge. However some cases , with a ruptured eardrum or a perforated
ear drum, it may cause discharge of blood or fluids from the middle ear.
The underlying cause of this is an infection in the middle ear or mastoid
bone.

What is Otitis Media ( Middle ear infection) ?
The ear can be divided briefly into 3 parts , the external middle and inner
EAR. Otitis media is the inflammation of the lining of the middle ear that
causes Recurrent otorrhoea ( ear discharge) through a perforation in the
ear. This could be
 Acute Otitis media: Acute inflammation , less than 3 weeks
Duration, usually caused by bacterial or viral infections with pus in
the middle ear ,may or may not be associated with perforated
eardrum
 Otitis Media With Effusion : without active inflammation, proceeded
by partially treated Otitis media , causing glue like discharge from
the ear.
 Chronic Otitis Media : Chronic inflammation more than 4 weeks with
a Persistent eardrum perforation , on and off ear discharge not
completely resolving
 Mastoiditis : Acute inflammation of the mastoid bone (bone located
behind the ear ) causing ear pain and swelling behind the ear

What are the symptoms ?
The symptoms include
 Ear discharge ( Profuse or scanty; mucoid /mucopurulent or watery ;
greenish /whitish /blood tinged ; foul smelling/ not foul smelling ).
 The ear discharge might not be obvious , sometimes only when u put
a cotton in ear ,it wets the ear
 Ear Blocked sensation
 Hearing impairment
 Red , painful tissue in the ear canal
 Ear pain / pain behind the ear
 Fever / giddiness / vomiting
 Headache
 Facial weakness or facial palsy

When to approach a doctor if I have ear discharge ?
It is advisable to consult an Ent surgeon immediately when you have an ear
discharge ,since it is can cause complications if left untreated . At home
adjuvant measures include avoid taking headbath , avoid swimming, avoid
using ear buds .
Symptoms of complications include
 Unresolving headache , pain behind the ear
 Neck pain /neck stiffness
 Projectile vomiting
 Impaired consciousness
 Giddiness (sensation of spinning )
 High Grade fever
What are the investigations that I have to do ?
Once you approach you clinician ,they might take one or few of the
investigations to confirm the diagnosis , chronicity, treatment plan and
prognosis
 Ear swab : The discharge from the ear may be sent for culture and
gram stain under microscopy to identify the organism and specific
antibiotic of choice
 Otoscope/ Endoscopic Examination: to assess the status of external
ear and ear drum
 Audiogram / hearing test : to assess the level & impairement of
hearing , status of ossicles ( bones in the ear )
 CT scan of the temporal bone : to identify the extent of infection ,the
nidus of infection, & complications if any
 MRI scan : in select cases only when suspected intracranial
complications
How is it treated ?
Depending on your underlying cause and disease extent ,your clinician
may advice
 Oral / intravenous antibiotics
 Topical ear drops
 Analgesics and Antipyretics
 Steroid nasal sprays
When do I need surgery?
This is subjective to patients disease progression. Any ear discharge that
is chronic more than 4 weeks ,usually needs surgery which could be either
 Tympanoplasty ( ear drum perforation repair)
 Grommet insertion ( for glue ear , placing small ventilation tube in the
ear )
 Mastoidectomy ( surgery to completely extirpate the infected mastoid
air cells and ear discharge

How can I prevent / avoid ?
Ear discharge can occur due to many bacterial / viral infections of middle
ear or even sometimes Fungal infection of external ear.
If you get ear discharge it is always advisable to immediately approach an
ENT doctor and start treatment immediately to avoid the complications
such as permanent hearing impairement/ spread of infection . Also if you
have risk factors such as

• Uncontrolled Diabetes
• Smoking
• Immunocompromised status due to any chronic illness ,
  Avoid self medications without prescription and seek immediate care.