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Discharge from the ears
Last reviewed: 23.04.2024
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[The main causes of discharge from the ear
Furunculosis. Infection of the hair follicles (usually staphylococci) leads to the appearance of furuncles in the outer third of the auditory canal, which is manifested by sharp pains that increase during chewing. In such cases, one should think about diabetes, which can make its debut in this way. With palpation, the tragus is painful, the pain increases when the auricle shifts, and the furuncle can be seen through the external auditory meatus. Treatment: thermal procedures (a bottle of hot water is applied to the ear), taking adequate doses of analgesics, topical ichthyol ointment and glycerin on a cotton swab (tampon every 12 hours). If there is cellulite or systemic manifestations, the patient is prescribed amoxicillin 250 mg after 8 hours and flucloxacillin 250 mg after 6 hours inside.
Inflammation of the middle ear. Pain in the ear can be followed by a copious pus (in case of perforation of the tympanic membrane). After a few days, the discharge from the ear stops. Treatment: taking antibiotics orally (eg, 250 mg amoxicillin after 8 hours, infants and children are given 1/2 of this dose for 3 days in the form of a syrup that does not contain sugar).
Continued discharge from the ear indicates mastoiditis. Muco-purulent discharge from the ear is sometimes observed in the absence of mastoiditis, especially if a tube is inserted into the ear canal for ventilation of the middle ear. The patient is prescribed antibiotics in accordance with the results of bacteriological research. It is necessary to constantly perform the "toilet" of the ear and remove the infected material from the external ear canal. If the discharge from the ear continues, it is necessary to send the patient to a specialist.
External otitis media. The disease is often observed in people suffering from eczema, seborrheic dermatitis or psoriasis (which is caused by scratches on the skin of the external auditory canal), as well as in people who spend a lot of time in the water (the skin of the external auditory canal becomes macerated). This also causes pain in the ear, there are abundant purulent discharge, often thick. The doctor's attempt to move the auricle or press on the tragus causes a sharp pain. Infected material from the external ear must be removed (if the inflammation is not too sharp, the ear should be gently rinsed with a spray from the syringe, if the acute ear toilet is produced with a cotton swab). These local procedures should only be carried out for a short time, as long-term use can lead to complications with a fungal infection that is difficult to cure. Antibiotics are advisable to apply topically in the form of drops, for example a 0.3% solution of gentamicin every 6 hours (sometimes they are used in combination with steroids), they are drilled into a turunda laid in the external auditory canal, or injected into the ear after it has been cleansed.
Chronic suppurative otitis media. It manifests itself as secretions from the ear and loss of hearing on the diseased ear in the absence of pain. The central perforation of the tympanic membrane indicates that the inflammatory process is localized in the lower anterior part of the middle ear. Treatment should be aimed at drying out secretions from the ear (frequent ear toilet, drops with antibiotics and steroids depending on the results of bacteriological examination). Surgical intervention is aimed at restoring the correct connection of the ears and eliminating the defect in the tympanic membrane.
Cholesteatoma. These are stratifications of scaly epithelial tissue (skin) in the middle ear and in the destroyed structures of the mastoid process (for example, in the labyrinth, in the meningeal membranes, in the facial nerve) with concomitant infection. In this case, discharge from the ear has an unpleasant odor; Perforation of the tympanic membrane often occurs in the posterior or upper part of it. The patient needs consultation with a specialist in order to remove all affected or infected bone tissue (mastioidectomy, atticotomy, atticoanthrotomy) and thereby save the ear. When using the operation it is possible to connect the postoperative cavity with the external auditory meatus, discharge from the ear continues until the cavity is covered with skin.
Diagnosis of secretions from the ears
Anamnesis. Acute otalgia with subsequent relief after the appearance of otorrhea is a sign of acute purulent otitis media (perforated stage). If the patient is fond of swimming or is stricken with seborrheic eczema, external otitis media should be assumed. A recent head injury or a surgical intervention on the temporal bone indicates the need to eliminate liquorrhea. Perforation of the tympanic membrane or chronic dysfunction of the auditory tube may be indirect signs of cholesteatoma. With an incomplete acute otitis media, mastoiditis can develop.
Physical examination. With otoscopy, perforation of the tympanic membrane, signs of external otitis, the presence of a foreign body or other causes of otorrhea can be detected. The expiration of a clear fluid can be a sign of liquorrhea, with trauma of discharge more often bloody. The detection of floating epidermal flakes in the wash liquid indicates cholesteatoma. Swelling in the parotid region, abundant growth of granulations in the external auditory canal and paralysis of the facial nerve can be observed with necrotic external otitis. Reddening and soreness of the mastoid process point to mastoiditis.
Additional studies. If suspicion of CSF is necessary, check for glucose or beta 2 -transferin. In the absence of obvious otoscopic signs, audiometry, computed tomography of the temporal bone or visualization by magnetic resonance imaging is performed, histological examination of the removed granulation tissue is performed.
To avoid untimely diagnosis of meningitis and other intracranial complications, antibiotic treatment should not be started without complete confidence in the diagnosis.
Treatment of secretions of the ears
Treatment depends on the final diagnosis. Antibiotics prescribe if there is an infection.