What does the nature of the discharge indicate?
The type of discharge helps to orient yourself in advance, although the final conclusion is made by the doctor after examination. Thick pus with pain and congestion is typical of otitis externa or otitis media. Mucopurulent discharge, which flows periodically for years, is characteristic of chronic otitis media with a persistent hole in the membrane. Scanty discharge with a very unpleasant odor and crumbly masses is alarming about cholesteatoma. Clear, watery fluid after a head injury may be spinal fluid. Blood appears when there is an injury to the ear canal, a ruptured membrane, or less often due to a tumor.
- Thick pus - acute otitis media
- Mucopurulent discharge for years - chronic otitis
- Putrid odor and crumbly masses - suspicion of cholesteatoma
- Clear fluid after injury is an alarming sign
- Blood - injury, membrane rupture, less often a tumor
- Curdled masses and itching - fungal infection
Main reasons
Otitis externa develops when the skin of the ear canal is damaged or remains wet for a long time: after swimming, when cleaning with cotton swabs, or wearing headphones. Otitis media produces a discharge when pus ruptures the eardrum - after which the pain usually subsides sharply. Chronic otitis media occurs with a constant hole in the membrane and periodic exacerbations, especially after exposure to water. In children, a common cause of sudden discharge is a foreign body. Otomycosis occurs after prolonged use of antibiotic drops. Separately, malignant otitis externa is distinguished in elderly people with diabetes - a severe lesion that spreads to the bone.
- Otitis externa
- Acute otitis media with membrane perforation
- Chronic suppurative otitis media
- Cholesteatoma
- Fungal infection of the ear canal
- Foreign body, more often in children
- Ear or head injury
- Malignant otitis externa in diabetes
Associated symptoms
The symptoms that accompany the discharge help to assess the situation. Pain and a feeling of fullness before the appearance of pus, followed by relief, indicate a rupture of the membrane in otitis media. Pain when pulling on the ear and when chewing is characteristic of external otitis. Congestion and hearing loss occur in any case, but rapid deterioration of hearing, dizziness and facial distortion indicate the spread of the process to the inner ear and facial nerve. Pain and swelling behind the auricle with protruding ear is a sign of mastoiditis that requires urgent help.
- Pain before discharge and relief after
- Pain when pulling on the ear
- Congestion and hearing loss
- Noise in the ear
- Dizziness and unsteadiness
- Swelling behind the ear and protruding ear
Survey
The main method is otoscopy, in which the doctor cleans the ear canal and examines the membrane: sees the perforation, its size and location, and the condition of the skin. Culture of the discharge with determination of sensitivity is necessary in cases of persistent or recurring flow, as well as in cases of suspected fungal infection. Hearing is assessed using audiometry, especially in chronic otitis media. Computed tomography of the temporal bones is indicated for suspected cholesteatoma, mastoiditis and complications, as well as before surgery. If there is discharge after a head injury, the examination is carried out urgently.
- Otoscopy with ear toilet
- Culture of discharge for flora and sensitivity
- Audiometry
- CT scan of the temporal bones for complications
- MRI for suspected intracranial complications
What to do and how to treat it
Before being examined by a doctor, the ear must be kept dry: do not bathe, do not rinse, do not instill drops or put cotton wool with solutions. This is important because if there is a hole in the membrane, some ear drops can damage the inner ear. Treatment begins with a careful cleaning of the ear, which is performed by a doctor. Then local drugs that are safe for perforation are selected, and in case of severe disease, temperature and spread of inflammation, systemic antibiotics are prescribed. For cholesteatoma, mastoiditis and persistent perforation, surgery is required. For prevention, it is important not to clean your ears with cotton swabs and protect your ear from water.
- Do not instill drops until examined by a doctor
- Keep your ear dry and do not swim or dive
- Ear toilet from a specialist
- Local preparations taking into account the condition of the membrane
- Systemic antibiotics according to indications
- Surgery for cholesteatoma and persistent perforation
- Avoiding cotton swabs and protecting your ears when swimming
