What is Otorrhoea?
Otorrhoea is a medical condition that affects the ear and it is characterised by discharge of fluids from the ears. This condition may be caused due to a variety of underlying conditions such as infection, inflammation, history of trauma, presence of tumor or other cancerous lesions. Quite often Otorrhoea is associated with other conditions such as earache, headache etc.
Types of Otorrhoea
Based on the type of discharge, otorrhoea is classified into 4 types as follows:
- Purulent otorrhoea
- Bloody otorrhoea
- Transparent otorrhoea
- Sero-hemorrhagic otorrhoea.
Symptoms of Otorrhoea
Otorrhoea is characterised by discharge of fluid from the ears. The type of discharge depends on the underlying cause of otorrhoea. Besides ear discharge, otorrhoea may be accompanied by the following symptoms:
- Vertigo or loss of balance
- Discomfort and tenderness in one or both ear
- Minor or partial hearing deficiency
- Stuffiness or fullness in ears
- Pressure build up in ears
- Nasal bleeding.
Causes of Otorrhoea
Ear discharge may be noted as ear wax makes its way out of the ears. This is a natural phenomenon and considered as normal. Other causes of abnormal ear discharge are listed below:
Ear Infection Causing Otorrhoea:
Ear infection is the most common cause of otorrhoea. Ear infection is usually caused by bacterial or viral infestation in the middle ear. This leads to fluid build-up in the ear which leads to fluid discharge from the ears.
Trauma as a Cause of Otorrhoea:
Trauma can be caused due to multiple reasons. Insertion of foreign objects such as hair pin, safety pin and cotton buds in the ear canal can lead to ear drum damage. Trauma can also be caused due to increase in the ear pressure while flying, sky diving, scuba diving. In some cases, rupture of the eardrum may be observed post exposure to loud music. This is called as acoustic trauma.
Otorrhoea due to Swimmer's Ear:
Swimmer's ear is a condition characterised by bacterial or fungal infection in the ear canal. This occurs secondary to break in skin over the walls of the ear canal, making it easy for bacteria and fungi to penetrate inside. Swimmer's ear generally occurs after spending long hours in water bodies and also in presence of eczema in ears or other physical irritation in the ear canals, which may make the ears more susceptible to infection.
Malignant Otitis Externa as a Cause of Otorrhoea:
It is a condition where there is damage in the cartilage and bones at the base of the skull.
Other causes of otorrhoea includes skull fracture (predominantly base of the skull) i.e. any break in the bones of the skull, mastoiditis i.e. infection over the mastoid behind the ears.
Risk Factors of Otorrhoea
The risk factors of otorrhoea includes:
- Repeated exposure to water over prolonged period of time while swimming and other water activities
- Insertion of foreign objects in the ear canals
- Accident or trauma to head and ear region
- Tissue injury in ears due to change in atmospheric pressure
- Head colds
- Underlying conditions such as acute otis media and chronic otis media associated with ear perforation; cholesteatoma; and dermatitis of the ear canal.
Diagnosis of Otorrhoea
Diagnosis of otorrhoea is done by an experienced ENT specialist or an otolaryngologist. A detailed cases history is obtained followed by physical examination of the ear. A sample of the ear discharge is obtained and sent to the laboratory for further investigations. These includes cytological tests and sample culture. In case of skull fracture, a Cerebrospinal fluid analysis test may also be considered. Once the test results are obtained, the cause of the ear discharge is clear and a treatment plan can be devised.
Treatment of Otorrhoea
Based on the pathological reports, treatment modality of otorrhoea is planned. In mild cases, the condition improves by itself and does not require active treatment. In some cases, an ear drop is prescribed based on the cause of the ear discharge. Heat compresses is often beneficial. In most of the cases, the patient is advised to wipe the ears with a warm wet wipes. He or she is advised to avoid exposing his or her ears to water until complete recovery. They are advised take shower with cotton balls placed in the ears. Additional medication may be given in case if the symptoms are associated with earache and fever. In case of a tear in the ear, which may not heal naturally, a special paper patch may be applied to accelerate healing. In severe cases, surgical intervention may be considered. Antibiotics may be considered in case of swimmer's ears and other ear infections.
Prevention of Otorrhoea
Ear discharge can be avoided by following certain precautionary methods. These include:
- Avoid inserting foreign objects in the ears
- Use ear plugs while swimming. Make sure that the ears are dried well post swimming
- Use ear protection while working in areas with loud noise
- Over-the-counter medications may be used to avoid development of otorrhoea
- Avoid exposure to loud music especially while using ear phones
- Avoid talking over phones for long hours.
Otorrhoea is a painful condition and the patient experiences utter discomfort due to it. Otorrhoea should not be neglected right from the onset of the symptoms. Severe infection in ear can also cause hearing loss and hence one must seek immediate medical help as soon as the symptoms are observed.