✍️ Dr Amit Jha
Dept. of ENT-HNS
Chitwan Medical College, Bharatpur-10, Chitwan
Email: [email protected]
Follow on Twitter @amitjha086
Discharging ear is a very common problem which brings hundreds of thousands of patients to Nepalese Otorhinolaryngologists or ENT Surgeons each year. A patient can have only one discharging ear or both. An ENT surgeon deals with all the diseases of ear, nose, throat, head and neck and their treatment. A large portion of my ENT patients comprise of those with discharging ears. Ear symptoms include discharging ear among other symptoms like ear pain, dizziness, hearing loss etc.
Ear discharge occurs in several ear diseases. Ear discharge can be watery, mucoid or purulent. It can be foul-smelling or odorless. These and other characteristics of the ear discharge based on its color, consistency, amount etc. help the treating doctor to make a working diagnosis. When you visit your ENT surgeon in his/her OPD with a discharging ear, you will be subjected to ear examination after being asked several questions regarding your symptom.
You will undergo examination in the OPD by a handheld illuminated device called an otoscope or auriscope. If the discharge is obstructing the view, a suction cannula will be inserted to clear the ear canal of any discharge or debris. This may be uncomfortable but not painful. Your other ear, nose and throat will be examined as well.
Similarly, you will be subjected to EUM (Examination Under Microscope) where magnification of this tiny organ is achieved by the use of a microscope to aid otoscopic findings. A PTA (Pure Tone Audiogram) will always be done if there is hearing loss along with discharging ear. This is done by placing special headphones and another device just behind the pinna of the ear. Likewise, according to severity of the disease or to confirm the diagnosis, an XRay or a CT scan would be requested.
As mentioned earlier, ear discharge is not a disease but a symptom. There are several ear diseases where discharge can occur. Discharge occurring due to perforated ear drum (a hole in the ear drum) is a very common condition in Nepal.
This disease is called Chronic Otitis Media (COM) and has various subtypes. The prevalence of COM varies around the world affecting 30% of the North American Eskimos, 4-6% of African population and less than 1% of individuals in the US and UK. In our country, it’s been reported to be 7.2%.
The definitive treatment of COM is surgery where, in the most basic type, the perforated eardrum is patched up. In more severe forms of the disease, the bone around the ear may be drilled open. Until the ear drum perforation persists, the patient will suffer from recurrent ear infections. Hence, taking a few precautions will prevent recurrent infection, and keep the ear dry and suitable for surgery.
- Avoid water entering into the ear. Keep Vaseline/cooking oil soaked and then squeezed cotton ball into the ear canal during the bath. Remove it after shower. A dry cotton ball will absorb water which will cause harm by entering into the middle ear cavity through the perforation in the ear drum. Similarly, avoid swimming.
- Do not install anything in the ear other than ear drops prescribed by your doctor. This includes oil, glycerine or extracts from any medicinal plants.
- Avoid cleaning of ear by yourself even with ear buds. Match stick, key, pins, pencil tips are a distant no.
- Avoid blowing your nose hard. This will cause the microorganisms from your throat to travel to middle ear cavity through the Eustachian Tube, thereby, causing inflammation and discharge. The best way to clear nasal secretions is to slowly pull it backwards down into the throat and spit it away.
- Similarly, in children, apart from the above precautions, there are other two things that should be taken care of. The suckling baby should be fed (including breastfeeding) with head in up and erect position so as to avoid passage of the liquid feed into the middle ear through Eustachian Tube (which is more horizontal in young children). Next, any episode of upper respiratory tract infection, should be promptly treated.
Ear discharge or any infection of ear should be taken seriously as there are risks of severe complications which may be fatal. Please visit your ENT surgeon promptly for further management and advice.