Article by Hearing Partners, contributed by Jennifer Lee, Clinical Audiologist at Hearing Partners
Ear discharge, also known as otorrhea, refers to any fluid draining from the ear. It can vary in type and colour, including yellowish or brownish wet earwax, clear fluid, blood, or pus. While it is a common condition among children, adults can also experience it.
This article will cover the causes of ear discharge, when to see a doctor and how to treat it. It will also cover some frequently asked questions about ear discharge.
Causes of Ear Discharge
Ear discharge is most frequently caused by infections, but there are other potential reasons. Here are some possible causes of ear infections:
Foreign objects stuck in the ear canal
Foreign objects in the ear canal are a frequent cause of ear discharge, particularly in children. Small items such as beads or ear stickers can become lodged in the ear canal, causing irritation, pain, and even infection. Other symptoms include a feeling of fullness in the ear, reduced hearing, and in some cases, bleeding.
External ear infection
Also known as swimmer’s ear, otitis externa is an infection of the outer ear canal. This infection is often caused by bacteria or fungi. If you have otitis externa, you may experience redness, swelling, itching in the ear canal or muffled hearing besides ear discharge.
Middle ear infection
A middle ear infection occurs when fluid builds up behind the eardrum, often due to bacteria or viruses. As pressure builds up behind the eardrum, it can result in pain, hearing loss, fever, and irritability. In severe cases, the eardrum may rupture, leading to the release of ear discharge and slight bleeding.
Ruptured eardrum
A ruptured eardrum can also result in ear discharge. Inserting objects such as cotton swabs too deeply into the ear canal, sudden changes in air pressure, certain middle ear conditions (e.g. cholesteatoma) or exposure to loud sounds can cause a perforation (rupture) in the eardrum.
When the eardrum is ruptured, it can result in bleeding and the release of any fluid that has accumulated in the middle ear. Other symptoms may include sharp ear pain, temporary hearing loss, tinnitus and dizziness.
Head trauma
Ear discharge due to head trauma is typically clear and watery. Trauma to the head or ear can damage the eardrum or surrounding structures, sometimes causing cerebrospinal fluid to leak if the injury is severe.
Accompanying symptoms of head trauma may include severe headache, dizziness, nausea, confusion, or hearing changes. Immediate medical attention is critical in such cases.
Nasopharyngeal cancer
Nasopharyngeal cancer is another cause of ear discharge, usually thick, foul-smelling pus. It’s a rare but serious cancer that originates in the nasopharynx, the tissue that connects the back of the nose to the back of the mouth.
In addition to pus, this cancer may cause symptoms like tinnitus, hearing loss, ear fullness, and persistent ear infections. Other common signs include a painless lump in the neck, headaches, nosebleeds, and blood in saliva.
When to See a Doctor for Ear Discharge
While ear discharge may resolve on its own in mild cases, there are situations where medical evaluation is essential. If you’re experiencing any of the following signs, visit the doctor as soon as possible.
- Persistent or worsening ear discharge
- Severe pain or swelling around the ear
- High fever
- Hearing loss or changes in hearing
- Discharge that is bloody or foul-smelling
- Dizziness or balance problems
How to Treat Ear Discharge
The treatment for ear discharge depends on the underlying cause. If the discharge is due to an ear infection or a minor ruptured eardrum, it often resolves naturally within a few days without medical intervention. However, if the condition persists, a doctor may prescribe antibiotic eardrops to treat the infection.
For severe cases of a ruptured eardrum, surgical repair may be necessary. On the other hand, If the ear discharge is caused by a foreign object lodged in the ear canal, a doctor will need to remove it carefully.
In situations where the discharge results from head trauma, you will be referred to a hospital for further evaluation and treatment.
FAQs About Ear Discharge
How is otorrhea diagnosed?
Doctors diagnose otorrhea by performing a physical examination of the ear using an otoscope to check for drainage or a ruptured eardrum. They may also ask about your symptoms, medical history, and any recent injuries. In some cases, additional tests, such as imaging, blood tests, or a sample of the discharge for lab analysis, may be required.
How long does otorrhea last?
The duration of otorrhea depends on its cause. Discharge caused by minor infections or injuries may resolve within a few days, while more serious conditions like severe infections or ruptured eardrums may take longer and require treatment. See your doctor immediately if you have ear drainage lasting more than three days.
Can I prevent ear discharge?
Adopting good ear care habits can help reduce the risk of ear infections, which are the main cause of ear discharge. These habits include drying the outer ear gently with a towel after swimming or bathing, avoiding inserting objects such as cotton swabs or fingers into the ear, and protecting the ears from loud noises and trauma.
