Otorrhea – Everything You Need to Know

The experience of having something leak from a body part that shouldn’t leak can be alarming.

This guide will tell you everything you need to know about discharge from the ear.

What is Otorrhea?

Otorrhea is a medical term that refers to any kind of discharge from the ear. Oto means ear and rrhea means flow.

It is not a condition in and of itself but is rather a symptom of something else.

Woman with ear

Symptoms

The symptoms of otorrhea all involve the flow or leakage of fluid from the ear.

This fluid may be:

» clear

» bloody

» yellow or green and pus-like

» odorless

» foul smelling

Along with otorrhea, there are often other symptoms related to the root cause.

These include the following:

» pain or discomfort

» dizziness or vertigo

» stuffiness and difficulty hearing

» a feeling of pressure

 

Causes

at doctorThere are a number of causes of this condition.

Some are pretty common and not a cause for much concern and others are rare and quite serious.

Ear Infection

An ear infection of the inner ear, middle ear, or outer ear can cause otorrhea.

This bacterial or viral infection can be painful and involves inflammation and a buildup of fluid in the ear.

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Not all ear infections involve otorrhea, but pus-like fluid draining from the ear can be a common symptom. Ear infection is the most common cause of otorrhea.

It is especially common in children.

In fact, the National Institute of Health says that “five out of six children will have at least one ear infection by their third birthday” and that ear infection is the most common reason a child will see a doctor.(1)

Foreign Body in the Ear

When something gets stuck in the ear, it can lead to pain and sometimes some fluid discharge from the ear.

Mastoiditis

When an ear infection isn’t treated, it can sometimes lead to mastoiditis. This is an infection of the mastoid bone.

According to the National Health Service, mastoiditis is more common in children.(2) Mastoiditis is a potentially life-threatening condition.

This condition is painful and will often lead to otorrhea. Along with otorrhea, other mastoiditis symptoms include fever, redness, and swelling.

Malignant Otitis Externa

In people with weakened immune systems, swimmer’s ear left untreated can sometimes lead to a more serious infection known as malignant otitis externa.

According to the journal Clinical Diabetes, over 90 percent of people who develop malignant otitis externa have diabetes.(3)

Other things that weaken the immune system like HIV or chemotherapy can also lead to the condition. This condition is painful and otorrhea is one of its trademark symptoms.

Yellow or green fluid will drain from the ear pretty steadily, and it tends to have a strong, foul odor.

Head Injury

An injury to the head like a concussion or a skull fracture can sometimes cause otorrhea. Head injuries can be extremely serious and life-threatening.

When otorrhea is involved, it can be a sign of something very serious. Clear fluid or blood draining from the ear suggests a very serious injury. This clear fluid is likely cerebrospinal fluid. Trauma to the head is the most common cause of a cerebrospinal fluid leak, according to the Cleveland Clinic.(4)

Eardrum Rupture

A hole or tear in the eardrum can cause otorrhea.

An eardrum rupture can be caused by injury or the insertion of a foreign body into the ear canal, an ear infection, pressure changes, or from exposure to extremely loud noises. Pain is usually the first symptom of an eardrum rupture, and otorrhea is typically the next symptom.

The fluid that drains from the ear might be clear, bloody, or pus-like.

Cholesteatoma

A cholesteatoma is a non-cancerous cyst or growth in the middle ear. Cholesteatomas can be caused by frequent ear infections, colds, or allergies. Otorrhea is a common symptom of these growths, and the fluid that drains from the ear will smell bad.

According to a study published in the journal Laryngoscope, children who get ear tubes are less likely to develop cholesteatomas.(5)

Otorrhea With Tubes

Otorrhea can sometimes occur after a child has tympanostomy tubes.

More than half a million children undergo ear tube surgeries each year, according to the American Academy of Otolaryngology–Head and Neck Surgery. (6) The actual cause of the otorrhea is usually an ear infection, but this is common after the insertion of tubes.

 

Treatment

A tablespoon of drugsThe course of treatment for otorrhea depends on the root cause.

You can’t treat otorrhea itself, only the condition that is causing it. For some causes of otorrhea, it will go away on its own without the need for treatment.

For many causes of otorrhea, treatment is necessary.

Treatment for Otorrhea From Ear Infections

The standard course of treatment for a bacterial ear infection is antibiotics.

If an ear infection is the result of a virus, antibiotics won’t help. If fluid remains built up in the ear over a long period of time, a doctor may perform a myringotomy.

Boston Children’s Hospital describes this as a small incision and the insertion of small tubes.(7)

This lets fluids like water, blood, or pus drain out from the ear. In children, a doctor may choose to insert tubes to help keep the middle ear dry and prevent future infections.

Treatment for Otorrhea With Tubes

Although putting in tubes is usually done to prevent ear infections, sometimes the tubes can lead to otorrhea.

The course of treatment for an infection in children with tubes may be different than treatment for a typical ear infection. According to the New England Journal of Medicine, the use of antibiotic-steroid eardrops is the best course of treatment for acute otorrhea in children with tympanostomy tubes.(8)

Treatment for Otorrhea From Foreign Body in the Ear

The only treatment that is typically needed from otorrhea from a foreign body in the ear is the removal of the foreign body.

It’s usually a good idea to have a doctor remove the foreign body from the ear in order to minimize further injury.

Treatment for Otorrhea From Mastoiditis

Doctor With Prescription MedicationTreatment for mastoiditis is usually a course of antibiotics and eardrops. The doctor will also need to clean the ear several times. In severe cases, where this course of treatment isn’t enough, surgery is necessary.

The surgery is known as myringotomy and involves making a small hole in the eardrum to allow fluid to drain out. In the most severe cases, the doctor will surgically remove the infected mastoid bone.

Treatment for Otorrhea From Malignant Otitis Externa

Treating malignant otitis externa usually involves a course of antibiotics. It tends to need a fairly long course of antibiotics to be effective and they may need to be taken intravenously. When the condition is quite severe and there has been significant damage to the tissues, surgery may be necessary.

Surgery will only be done to remove the damaged tissue after the infection has been totally cleared.

Treatment for Otorrhea From Head Injury

Close monitoring is usually necessary in the case of a head injury. It’s also important to avoid strenuous activity in the weeks following a head injury. In some cases, surgery may be necessary.

Various kinds of therapies and medication may be necessary as well. In the case of a cerebrospinal fluid leak from the ear, treatment may be as simple as a period or rest. It may also involve a lumbar drain or even surgery.

Treatment for Otorrhea From Eardrum Rupture

In most cases, a ruptured eardrum will heal on its own over time. While the eardrum is healing, it’s very important to not let it get wet.

Avoiding swimming and using special care when bathing is key. To help relieve pain, the use of heat and the administration of pain relieving medicines may be used. When the eardrum is not healing on its own within a reasonable time frame, a doctor can place a patch over the hole or tear in the eardrum.

In the worst cases, surgery will be necessary. Surgery is typically only necessary for really large tears or for perforations on the edges of the eardrum. In this surgery, a doctor will repair the eardrum using a piece of the patient’s own tissue.

Treatment for Otorrhea From Cholesteatoma

A cholesteatoma will typically need to be removed surgically.

According to the Mount Sinai Hospital, surgery is not always needed urgently, but “once a cholesteatoma is found, surgical treatment is the only choice.” (9)

The surgery will remove the disease from the bone and repair the eardrum if necessary. Surgery will end symptoms like otorrhea and will prevent more serious complications from occurring.

 

When to See a Doctor

Otorrhea is a symptom that should almost always trigger a visit to a doctor. It can be a symptom of a mild problem, but it could also be the sign of something quite serious. It’s especially important to see a doctor when fluid draining from the ear is clear, bloody, or has a foul odor.

It is also important to make note of any other symptoms that are happening along with the otorrhea. If you are experiencing pain, trouble hearing, dizziness, or any other symptom, it’s a good idea to see a doctor. Make sure the doctor is aware of all the current symptoms.

If you have drainage from your ear, you are experiencing otorrhea. Otorrhea can be annoying and embarrassing, so you will want to find out the root cause and start treatment as soon as possible.

This condition can be caused by many different things, so it’s typically important to visit a doctor. This is especially true because otorrhea can sometimes be a sign of a very serious and even life-threatening condition.

» Make note of any other symptoms you are experiencing.

» Make note of the color, odor, and thickness of the fluid draining from your ear.

» Visit your doctor as soon as possible to find the cause of the otorrhea.

» Follow the doctor’s instructions.


References

(1)https://www.nidcd.nih.gov/health/ear-infections-children
(2)http://www.nhs.uk/conditions/mastoiditis/Pages/Introduction.aspx
(3)http://journal.diabetes.org/clinicaldiabetes/V18N32000/pg102.htm
(4)https://my.clevelandclinic.org/health/articles/cerebrospinal-fluid-leak
(5)https://www.ncbi.nlm.nih.gov/pubmed/20058316
(6)http://www.entnet.org/content/ear-tubes
(7)http://www.childrenshospital.org/conditions-and-treatments/conditions/myringotomy-ear-tubes
(8)http://blogs.nejm.org/now/index.php/loud-and-clear-how-to-treat-acute-otorrhea-in-children-with-tympanostomy-tubes/2014/02/19/
(9)http://www.mountsinai.org/patient-care/service-areas/ent/areas-of-care/hearing-and-balance/cholesteatoma