Ear Discharge: Causes, Diagnosis, Treatment

There are many causes of ear drainage. The most common type of ear drainage is cerumen, which keeps the ear clean and healthy. Blood, transparent fluid, and pus are other forms of drainage and discharge. These may show a ruptured eardrum or an ear infection.


What is Ear Discharge (Otorrhea)?

  • Ear discharge, also known as otorrhea, is any fluid that comes out of the ear. Most of the time, your ears leak earwax.
  • This is an oil that your body produces naturally. The job of earwax is to make sure that dust, bacteria, and other foreign bodies don't get into the ear.
  • However, other conditions, such as a ruptured eardrum, can cause blood or other fluids to drain from the ear.
  • This type of discharge is a sign that your ear has been injured or infected and requires medical attention.

Types of ear discharge

  • Clear Discharge: Often due to external ear canal infections or excessive moisture.
  • Bloody Discharge: This could indicate a perforated eardrum, trauma, or infection.
  • Yellow or Green Discharge: Typically associated with bacterial infections like otitis media.
  • Thick and White Discharge: This may indicate fungal infections like otomycosis.
  • Pus-like Discharge: Commonly seen with infections such as acute otitis media or chronic otitis externa.

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What are the causes of Otorrhea (ear discharge)?

Ear Wax

  • Earwax is a common occurrence in the ear and may appear in white, yellow, or brown hues.
  • The purpose of earwax production is to maintain ear cleanliness and health, as well as to protect against infections.
  • When earwax comes into contact with water, such as during bathing or swimming, it may take on a liquid consistency resembling discharge.

Transparent Liquid

  • Water may accumulate in the ear after swimming or bathing, resulting in clear fluid discharge.
  • To prevent swimmer's ear, individuals can gently dry their ears using a hairdryer on low heat or a towel.
  • Seeking immediate medical attention is crucial if a clear liquid is noticed in the ears following a head injury to avoid potential complications.

Blood

  • In some cases, a minor injury or scratch to the ear canal can result in a small amount of blood discharge from the ear.
  • When an individual has a ruptured eardrum, they may observe the presence of blood, pus, or clear fluid coming out of the ear.
  • The eardrum, located between the ear canal and the middle ear, can rupture if it sustains a small hole due to certain factors.

Pus or Cloudy Liquid

  • The presence of pus or a cloudy fluid discharge from the ear is often an indication of an infection in either the ear canal or the middle ear.
  • The ear canal serves as a tube that connects the outer ear to the middle ear.
  • Otitis media, which refers to an infection in the middle ear, can also lead to the discharge of fluid in the ear.
  • In about 10% of cases, ear infections can result in a ruptured eardrum.
  • Common causes of ear infections include colds, the flu, or injuries to the ear.
  • Some individuals are more prone to developing ear infections than others.
  • People can also have the following signs if they have an ear infection:

Ruptured Eardrum

  • A perforated eardrum can be caused by different factors like pressure from an ear infection, exposure to loud noises close to the ear, inserting objects too deeply into the ear canal, sudden changes in air pressure, or ear injuries such as a blow to the ear.
  • Signs of a perforated eardrum might consist of ear pain followed by sudden relief, ringing in the ear (tinnitus), and hearing loss in the impacted ear.
  • If individuals observe any bleeding from the ear after a head injury, it is recommended to seek immediate medical attention to evaluate and manage potential complications.

Ear discharge Diagnosis

  • An otoscope is a type of illuminated microscope commonly used by medical professionals to examine the ear and pinpoint the cause of any drainage issues.
  • The pneumatic otoscope, on the other hand, is specifically designed to showcase the movement of the eardrum in response to pressure changes, achieved by releasing a small burst of air into the ear canal.
  • Tympanometry is a diagnostic test that plays a crucial role in evaluating the health of the middle ear by analyzing how it responds to varying levels of pressure; this procedure typically involves inserting a probe into the ear canal.
  • During an ear exam, healthcare providers may conduct a hearing test and utilize a tuning fork to gauge the individual's hearing abilities as part of the comprehensive assessment process.

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What are the Treatment Options for Ear Discharge (Otorrhea)

  • Doctors prescribe antibiotics for ear infections, which can be administered orally or as ear drops depending on the location of the infection.
  • To relieve earaches, warm compresses and over-the-counter pain relievers like ibuprofen are recommended to help alleviate discomfort.
  • A ruptured eardrum typically heals without treatment within a few weeks to 2 months, but keeping the ear dry and protected from loud noises and shocks can aid in the healing process and prevent infection.
  • In cases where the eardrum does not heal spontaneously, surgical intervention may be necessary to place a patch of new skin over the hole.
  • Treatment for ear fluid may involve antibiotics prescribed by doctors, a combination of decongestant and antihistamine to minimize congestion, and the insertion of an auditory tube by a doctor if initial treatments are ineffective in draining fluids.

When to visit an ENT doctor?

Call your healthcare provider if:

  • The discharge is white, yellow, clear, or bloody.
  • The discharge is the result of an injury.
  • The discharge has lasted more than 5 days.
  • There is severe pain.
  • The discharge is associated with other symptoms, such as fever or headache.
  • There is hearing loss.
  • Redness or swelling is coming out of the ear canal.
  • Facial weakness or asymmetry.

How can I prevent ear discharge?

While it may not be possible to prevent all causes of ear discharge, some tips can help protect your ear from damage, including:

  • Avoiding inserting foreign objects, such as cotton swabs, pens, or hairpins, into the ear
  • Dry your ears thoroughly after washing or swimming
  • Allow water to drain from the ears after bathing or swimming by tilting the head to each side
  • Take precautions to avoid pressure damage, such as when driving or flying
  • Wearing earplugs to muffle loud noises, such as heavy machinery or large speakers at concerts
  • Use over-the-counter ear drops to help clean your ears after swimming

Citations

Ultrasound-guided Greater Auricular Nerve Block for Emergency Department Ear Laceration and Ear Abscess Drainage An evaluation of postural stability and the effects of middle-ear drainage on vestibulo-spinal reflexes of children with chronic otitis media with effusion Lymphatic drainage of the external ear Intracranial complications of acute and chronic infectious ear disease: A problem still with us.
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Frequently Asked Questions

1. How do you stop ear discharge naturally?

  • Apple cider vinegar with ear drops in warm water
  • Mix equal parts apple cider vinegar with warm, not hot, water.
  • Apply 5 to 10 drops to each affected ear with a clean dropper bottle or baby syringe.
  • Cover your ear with a cotton ball or clean cloth and lie on your side so that the drops enter and settle in your ear.

2. How to clean ear wax?

  • For a safe method of cleaning ear wax, consider utilizing warm water irrigation or purchasing over-the-counter ear drops to help soften the wax.
  • It is important to refrain from inserting any objects into the ear canal, as this can potentially cause damage.
  • If you are experiencing severe symptoms, it is advisable to seek medical assistance promptly to address the issue effectively.

3. How to remove stubborn ear wax at home?

  • To address persistent ear wax at home, consider utilizing non-prescription ear drops to help soften it, followed by delicately irrigating the ear canal with lukewarm water.
  • It is advisable to refrain from using any objects to extract the wax and to consult a healthcare professional if necessary.

4. Is ear drainage a good sign?

  • Normal ear discharge includes water that comes out after getting out of a pool or shower and earwax.
  • Earwax exists to protect your ear from dust and other foreign objects that can cause bacteria to build up.

5. Why is my ear draining a smelly fluid?

Ear infections generally occur in your middle ear. They can be bacterial or viral. Infections are often painful due to inflammation and buildup. An ear infection can cause discharge and you may notice a bad smell.

6. What does ear discharge look like?

Ear discharge (otorrhea) is drainage from the ear. The runoff, like pus, may be watery, bloody, or thick and whitish (purulent). Depending on the cause of the discharge, people may also have an earache, fever, itching, vertigo, ringing in the ear (tinnitus), and/or hearing loss.

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