Otorrhea overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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Ear discharge may be caused by an irritation or inflamed tissue within the mastoid, ear canal, or middle ear.

## Pathophysiology

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When the middle ear becomes acutely infected by bacteria, pressure builds up behind the ear drum, usually but not always causing pain. In severe or untreated cases, the tympanic membrane may rupture, allowing the pus in the middle ear space to drain into the ear canal. If there is enough of it, this drainage may be obvious. Even though the rupture of the tympanic membrane suggests a traumatic process, it is almost always associated with the dramatic relief of pressure and pain.

## Natural History, Complications and Prognosis

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Instead of the infection and eardrum perforation resolving, drainage from the middle ear can become a chronic condition. As long as there is active middle ear infection, the eardrum will not heal.

## Diagnosis

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### CT

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CT of temporal bones may be performed for cholesteatoma, mastoiditis, and CSF otorrhea.

## Treament

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### Medical Therapy

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Foreign bodies can be removed with alligator forceps under magnification. In a simple case of acute otitis media in an otherwise healthy person, the body's defenses are likely to resolve the infection and the ear drum nearly always heals. Antibiotic administration can prevent perforation of the eardrum and hasten recovery of the ear.

## References

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