Otorrhea Definition

Otorrhea is drainage or discharge of fluids from the ear along with inflammation and infections. Common reasons of this discharge are trauma to the brain or entry of any object into the ear. However, different causes of the discharge are evident through the types of drainage experienced by the individuals. The infection can begin from various parts of the ear such as the ear canal, the cranial vault or the middle ear.

Chronic otorrhea is when the middle ear gets infected and inflamed while the tympanic membrane gets perforated and the condition remains the same for 6 – 12 weeks. Such an ailment is common among infants and children rather than adults.

Types of Otorrhea

  • Blood Otorrhea: It is a rare condition in which a person sweats blood under excessive emotional or physical pressure. It is accompanied with continuous and painless bleeding because the blood capillaries connected to the sweat glands rupture. It could lead to bleeding from the ear.
  • Purulent Otorrhea: The outpour is thin and hazy where Poly-morpho-nuclear leukocytes fill the epithelial layer and appear edematous. Commonly, a bacterial contagion of the Eustachian tube is the cause of this type of a discharge. Other infections like tympanogenic meningitis can also result in purulent otorrhea when the inflammatory cells enter the internal auditory canal.
  • Cerebrospinal Otorrhea: The ear secretes cerebrospinal fluids and it happens in case of meningitis, brain tumors, brain infections, skull fracture, brain injuries or after an ear surgery.

Causes of Otorrhea

  • Ear infections: Infection of the inner ear causes fluids to be discharged due to virus or bacteria called otitis media. In this condition, a white, thick and milky substance gathers together and is expelled out from the ear.
  • Swimming: Prolonged exposure to water makes people more susceptible to otorrhea. An infection of the outer ear is called otitis externa or swimmer’s ear. Moreover, the presence of viral and bacterial micro organisms are common in water, contact with contaminated water can lead to inflammation, skin irritation and a ruptured ear drum.
  • Objects: Inserting objects into the cavity of the ear is common among children. These objects may damage the ear in various ways and may contain germs on their surface which gain easy access into the ear when these objects are inserted into the ear.
  • Injury: Direct or indirect injury to the ear can result in the discharge of fluids from the ear. This is also possible in case of a trauma to the brain where the cerebral fluid seeps into the passage of the ear and is drained out from there. Similar effects can be caused due to inner tissue injury or blunt force acting on the ear.
  • Barotrauma: It is a condition that refers to damage of the ear tissue. Difference in pressure inside and outside the eardrum results in the damage which may be due to travelling to a place at a higher altitude.

Symptoms of Otorrhea

  • Vertigo or unsteadiness
  • Bleeding from the nose
  • Partial loss of hearing
  • Feeling of pressure inside the ear, similar to the pressure experienced under water
  • Sensation of stuffiness in the ear
  • Feeling of pain and discomfort in one or both ears
  • High body temperature
  • Pain in the temples

Characteristics of the Different Types of Discharge

Otitis externa

  • Acute bacterial infection causes discharge of scant white & thick mucous
  • Chronic bacterial infection leads to discharge of blood along with granulation tissue
  • Fungal infection can result in a fluffy discharge and the color may vary between blue-green, yellow, black, white, gray, black, etc. Image Source: en.wikipedia.org

Otitis media

  • Causes perforation of the tympanic membrane
  • Purulent white to yellow discharge in case of an acute condition along with deep pain
  • Serous otitis media discharges clear mucous & occurs with allergic rhinitis
  • In case of chronic suppurative otitis media, no pain is experienced but purulent mucous is expelled from the ear
  • Acute discharge in spite of an absence of any immunodeficiency disease or chronic ear problem is caused due to otitis externa Image Source: en.wikipedia.org

Risks Factors of Otorrhea

The following people are at a greater risk than others in terms of being subjected to otorrhea:

  • People suffering from fever
  • People who have recently experienced serious head trauma
  • Diabetics
  • People who have immunodeficiency diseases
  • Erythema of the periauricular tissue or the ear
  • Dysfunction of the cranial nerve

Tests for Otorrhea

  • Discharge can be tested for glucose or beta 2 – transferring to check if it is a cerebrospinal fluid
  • Audiogram
  • CT scan of the temporal bone
  • MRI
  • Biopsy in case auditory canal granulation tissues are present in the discharge

Otorrhea Treatment

  • Warm compress: A cloth soaked in warm water can be placed on the ear for five minutes. It helps to reduce the pain and allows the fluids to flow easily. The head should be placed parallel to the ground while placing the cloth on the ear, between the ear and the ground.
  • Garlic: It has antibiotic properties that can help in case of a middle ear infection. The juice from the garlic cloves can be squeezed out and applied to the ear with an eye dropper and then using a hair dryer to dry it. This should be repeated twice a day for speedy recovery.
  • Gravity: The fluid from the ear needs to be completely removed before any other method can be used to treat the ailment. The best way to do this is to lie with the ear parallel to the ground to allow the force of gravity to help remove the fluids from the cavity of the ear. Creating a vacuum effect by using a finger inside the ear and keeping some cotton handy to clean the fluids is another way of clearing the ear.
  • Vinegar: White vinegar has anti bacterial properties and alcohol has a drying effect. Both these substances can be combined in equal quantities and applied to the ear using a dropper. The ear can be placed parallel to the ground to remove the discharge. The procedure should be repeated twice a day.
  • Steam Inhalation: Steam inhalation is used to release congestion. In the same way placing one’s head over a vessel of warm water and covering with a towel is also helpful in removing the fluids from the ear. The ear should be placed in a way that allows it to be exposed to the steam.

When to Visit a Doctor?

It is always advisable to take medical advice from a doctor as soon as symptoms of otorrhea are observed. Early diagnosis helps to know the correct cause behind the discharge and aids in treating the condition.

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