The medical term used to describe ear drainage is otorrhea. This is a condition that may happen due to trauma or an ear infection (including otitis media, swimmer’s ear, and others). In some cases, otorrhea may indicate a more serious health condition, especially if it occurs after a head injury. The treatment for this condition depends on the underlying cause.
In other words, otorrhea is drainage that comes out of your ear. In some cases, people refer to otorrhea as “runny ears” or “watery ears”. Mostly, people develop this disorder due to a ruptured eardrum caused by an ear infection. The fluid begins to drain out of the ear because there is a hole in the eardrum. However, you may experience otorrhea due to other conditions, including swimmer’s ear, head trauma, or when a foreign object gets stuck in the ear.
Generally, this condition is very common, and it is associated with multiple (benign) and serious disorders. In most cases, people develop it due to ear infections.
Types of Otorrhea
Physicians have divided this condition into 5 types. For example:
- Purulent (drainage contains pus)
- Serous (contains serum, a protein-rich liquid in the blood)
- Bloody (contains blood)
- Mucoid (contains mucus)
- Clear (thin and watery)
Symptoms
While the primary symptom of otorrhea is drainage from the ear, it may also cause other symptoms. Furthermore, the drainage can be odorless, foul-smelling, thin, thick, clear, yellowish, or green in color. Check below for other symptoms of otorrhea:
- Ear pain
- Itching
- Tinnitus (ringing in the ears)
Sometimes, people may develop more severe symptoms. These include:
- Hearing loss
- Erythema (redness of the skin around the ear)
- Fever
- Vertigo
- Cranial nerve dysfunction (including problems with speaking, swallowing, or seeing)
From time to time, people with otorrhea also have a recent head trauma. However, those who suffer from diabetes or have a weakened immune system are at increased risk for otorrhea complications. Do not hesitate to contact your healthcare professional if any of the previous symptoms occur.
Causes
Most diagnosed cases of otorrhea occur due to the following causes. Check below the most common causes:
- Ruptured eardrum
- Acute and chronic middle ear infections
- Outer ear infections (including fungal yeast infections of the ear canal, swimmer’s ear, and others)
- Unknown objects that get stuck in the ear
Otorrhea may also occur due to less common causes. For example:
- Cancer of the ear canal
- Cholesteatoma (abnormal skin growth behind the eardrum)
- Malignant external otitis (a severe infection of the external auditory canal and skull base)
- Fractures at the base of the skull
Risk Factors
While otorrhea can affect anyone, some factors may increase the risk of developing it. Check below some examples:
- Age – Mostly, otorrhea is diagnosed in children between 6 months and 2 years.
- Upper respiratory infections – Colds, flu, and other infections often increase the risk of developing otorrhea.
- Weakened immune system – The immune system can be compromised due to diabetes, HIV infection, medicines, and other factors.
- Underlying skin conditions – These include psoriasis and eczema (also known as atopic dermatitis).
- Genetic factors
- Narrow ear canals, ear devices, or head trauma
- Secondhand smoke
- Water exposure
- Poor air quality
What Are The Long-term Effects of Otorrhea?
People with otorrhea may also experience some complications, especially if they leave it untreated. Check below some examples:
- Developmental and speech delays
- Permanent hearing loss (deafness)
- Mastoiditis
- Facial nerve palsy
- Necrotizing otitis externa
- Meningitis
- Brain abscess
- Other severe health problems, including sigmoid sinus thrombosis, otic hydrocephalus, and others
- Chronic suppurative otitis media
- Labyrinthitis
- Cerebrospinal fluid (CSF) leak
This document does not contain a complete list of otorrhea complications. However, you can consult with your doctor about ways to reduce the risk or even prevent the previous complications.
How to Prevent Otorrhea?
Most causes of otorrhea are unavoidable, which makes it impossible to prevent this condition at all. However, doctors may recommend specialized earplugs when swimming or bathing, as this increases your risk of developing this condition.
Diagnosis
First, physicians perform a physical examination, which includes the following things. For example:
- Checking whether you have a fever
- Examination of the ear canal for abnormalities linked to the disease (including drainage, infection, or a ruptured eardrum)
- Swelling around the ear, jaw, or neck
- Examination of the skin around the ear for redness and inflammation
While most of the time, doctors diagnose otorrhea with a physical examination only, sometimes they may perform the following tests to confirm the diagnosis. Check below some of them:
- Audiometry – This test is used to measure the range and sensitivity of the sense of hearing.
- CT (computerized tomography) scans – This imaging test is used to get cross-sectional images of the middle ear.
- MRI (magnetic resonance imaging) scans – This is another imaging test used to get more detailed images of the head. It often helps identify CSF leaks.
- Cranial nerve examination – People who have had a recent head trauma may have problems with seeing, swallowing, or speaking. Thus, doctors will perform this examination to test your cranial nerves for proper function.
- Culture – If your doctor suspects otorrhea is caused by an infection, they may get a sample of the drainage to check for the presence of bacteria or fungi.
Treatment
Usually, the treatment for otorrhea focuses on the underlying cause. For instance, if you have ear drainage due to a bacterial infection, doctors may recommend antibiotics (including antibiotic ear drops) to treat the primary infection.
However, if you have otorrhea due to a ruptured eardrum, it heals on its own within several weeks. In more severe cases, people may need a tympanoplasty to close the hole. When it is not possible to determine the exact cause of otorrhea, you can be referred to an otolaryngologist (ENT) for further evaluation.
Frequently Asked Questions
Is otorrhea an infection?
While the most common cause of otorrhea is infection, it does not necessarily mean you have an infection, even with otorrhea. Commonly, otorrhea is a symptom of an infection, but not an infection itself. Sometimes, this condition may occur when an unknown object is stuck in the ear.
Is otorrhea contagious?
While the condition itself is not contagious, some ear infections may spread to other people. For more details, discuss it with your doctor.
When should I go to the ER?
You should call 911 or go to the nearest emergency room (ER) if you develop ear drainage following a recent head trauma or experience problems with speaking, seeing, or swallowing. Ask your healthcare professional if you have additional questions.
