Ear Discharge
Ear discharge (otorrhea) refers to any fluid coming from the ear canal. Its colour, odour and duration give important clues about the cause. Recurrent or persistent discharge should always be evaluated by an ENT specialist.
Common causes
- Outer ear canal infection (swimmer's ear): develops after swimming or ear-poking; the ear is painful and touching the auricle makes it worse.
- Acute middle ear infection with perforation: accumulated pus may rupture the eardrum and drain; pain typically eases once the discharge starts.
- Chronic otitis media: recurring, sometimes foul-smelling discharge through a persistent eardrum perforation, often with hearing loss.
- Cholesteatoma: an accumulation of skin debris in the middle ear that erodes bone and always requires treatment; a key cause of stubborn, smelly discharge.
- Children with ear tubes: infection fluid may drain through the tube — usually responds well to drops.
- Fungal infections: itching is prominent, with cotton-like debris in the canal.
Warning signs
Clear, watery discharge after head trauma may be cerebrospinal fluid leakage and is an emergency. Seek prompt care if discharge is bloody or accompanied by severe vertigo, facial weakness or high fever.
Diagnosis and treatment
Microscopic cleaning of the ear is the first step of both diagnosis and treatment. Outer ear infections usually settle with appropriate drops. With perforations and chronic infection, the ear is kept dry and, once infection is controlled, surgical repair of the eardrum (myringoplasty/tympanoplasty) can be planned. Cholesteatoma requires surgery.
Prevention
- Never poke the ear with swabs or other objects.
- Keep water out of a discharging ear; use vaseline-coated cotton when showering.
- People with eardrum perforations should use earplugs when swimming.
Frequently Asked Questions
What causes fluid or discharge from the ear?
Common causes of ear discharge include outer ear canal infection (swimmer's ear), a ruptured eardrum from middle ear infection, chronic otitis media and fungal infections. The colour, odour and duration of the discharge give important clues to the cause.
What is swimmer's ear and how do I recognise it?
Swimmer's ear is an outer ear canal infection that develops after swimming or poking the ear. The ear is painful, and touching or pulling on the outer ear noticeably worsens the pain.
Why does my ear discharge smell bad?
Stubborn, foul-smelling discharge can be a sign of chronic otitis media through a persistent eardrum perforation, or of cholesteatoma. Because cholesteatoma erodes bone and always needs treatment, this kind of discharge should be checked by an ENT specialist.
When is ear discharge an emergency?
Clear, watery discharge after head trauma may be cerebrospinal fluid leakage and is an emergency. You should also seek prompt care if the discharge is bloody or comes with severe vertigo, facial weakness or high fever.
How is ear discharge treated?
The first step is microscopic cleaning of the ear; outer ear infections usually settle with appropriate drops. With eardrum perforations and chronic infection, the ear is kept dry and, once the infection is controlled, surgical repair of the eardrum may be planned.
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