The source of ear discharge in adults and children may be from the external auditory canal, middle ear and mastoid cavity (the airy cavity part of the bone where the ear is located) and has a wide variety of reasons. Ear discharge in children often occurs due to acute middle ear infection coming from the external ear canal through a temporary hole in the eardrum, or due to chronic middle ear infection coming from the external ear canal through a permanent hole in the eardrum. In adults, it often occurs due to external ear canal inflammation or chronic middle ear inflammation in patients with permanent eardrum perforation.
Ear discharge originating from the external auditory canal
External ear canal infections:
Ear discharge may occur as a result of inflammation in the external ear canal, usually following trauma to the external ear canal or swimming. Trauma to the external ear canal can occur due to mixing of the external ear canal with cotton ear swabs or another foreign object, ear washing with pressurized water, in-ear hearing aids, and even thermometers that measure from the ear. In inflammation of the external ear canal, there is pain along with discharge.
Infection of the external ear canal can be caused by bacteria, viruses and fungi.
An external ear canal infection called necrotizing otitis extena is very rare.
This disease is less common in children than in adults. It is generally seen in immunosuppressed patients, poor general health, and diabetic patients.
External ear canal inflammation rarely occurs as a regional infection spreads to the ear. It primarily occurs in the form of inflammation of the teeth and salivary gland (patotis) spreading to the outer ear. The causative agent is a bacterium called actinomyces israeli. It is treated with surgical debridement (cleaning of tissues that have lost their vitality) and long-term antibiotics.
Chronic dermatitis and eczema of the external auditory canal is also the cause of inflammatory ear discharge. Bacterial or fungal infections on top of this situation can complicate the situation. In this disease of the outer ear canal skin, painless chronic discharge occurs. This eczema condition has recently been diagnosed in the external ear canal. It may be caused by drops containing antibiotics or other ingredients.
Infection of the cysts of the first branchial cleft (a congenital ear anomaly where the opening of the canal opens into the external auditory canal or in front of the ear). In rare cases, it may be the cause of discharge from the external auditory canal.
Tumors originating from the external auditory canalmay be the cause of external auditory canal discharge.
Cholesteatomas are an abnormal, non-cancerous skin growth that can develop in the middle part of your ear, behind the eardrum. It can be a birth defect, but is most often caused by recurrent middle ear infections. A cholesteatoma usually develops as a cyst or sac that retains old layers of skin. ) is another cause of discharge originating from the external auditory canal.
Ear discharge originating from the eardrum, middle ear and mastoid cavity
If physical examination reveals discharge originating from the external auditory canal. If there is no cause, the source may be the eardrum, middle ear or mastoid cavity.
Granular myringitis:
It is a rare inflammatory process in the eardrum, the cause of which is unknown. Granulation tissue and mucosified epithelium appear in patchy fashion on the membrane. If it is not infected, it causes a thin, transparent discharge.
Acute otitis media:
In acute otitis media, the discharge may be bloody, mixed with mucus, or pus-colored. and is short-term. Ear pain decreases after inflammatory discharge. In addition, patients who have had a tube applied to the eardrum may experience bloody, inflammatory discharge immediately after or in the future. Discharge due to the ear tube may be due to the closure of the tube opening, inflammation of the middle ear after swimming or bathing, or inflammation in the nasal area being carried to the middle ear through the eustachian tube.
Coalescent or chronic bacterial otomastoiditis:
The name of the bone inside our ear is the temporal bone. The mastoid is a part of this bone. There are air cavities inside this piece. Inflammation of these spaces is called mastoiditis.
Acute and chronic conditions Cholesterol or otomastoiditis may develop as a result of neglect or inadequate treatment of rhinitis. This condition causes tenderness in the mastoid area behind the ear, ear pain, and inflammatory ear discharge. In this case, the external ear canal is painful and swollen, the auricle is directed downwards, there is pain and swelling behind the ear, and systemic fever accompanies the findings. If ear and intracranial complications develop, symptoms related to these conditions are added to these findings.
Cholesteatomas:
Cholesteatoma is in the middle ear, behind the eardrum, outside. It is an abnormal, non-cancerous skin growth that can develop in the ear canal. This may be a birth defect, but is most commonly caused by frequently recurring middle ear infections. This condition is the cause of painless, recurrent inflammatory ear discharge in children and adults. Long-term hearing loss accompanies this condition. If the cholesteatoma tissue has not caused damage to the surrounding bone tissue, dizziness is not observed.
Granulomatous diseases:
Histiocytosis, Wegener's syndrome, Churg-Strauss syndrome, tuberculosis, which are quite rare. If there is ear involvement in diseases such as ear discharge, ear discharge may be observed.
Tumors:
Less commonly, the causes of bloody or inflammatory ear discharge are the external auditory canal, middle ear or mastoid. We can count the tumors arising from the cavity. We may present with ear itching, ear fullness or ear discharge. Or they may not show symptoms until a bacterial infection is added.
Breast, lung, kidney, prostate and stomach tumors can potentially spread by being carried through the blood to the bone where the ear is located (temporal bone). However, this situation is quite rare. Temporal bone involvement may also occur due to leukemia and lymphoma. When the temporal bone is involved due to tumor; Conductive or neural hearing loss, earache, mastoiditis, facial nerve paralysis, inflamed and bloody ear discharge may be observed.
Cerebrospinal fluid discharge from the ear:
This condition may be continuous or intermittent for various reasons. A transparent liquid spontaneously leaks into the eardrum, which is already pierced, without any reason. It may come from the external ear canal or through the ear tube previously placed. This situation is likely due to an underlying congenital anomaly or an opening after surgery. Cerebrospinal fluid leakage from the ear may also occur due to direct trauma, tumor complication, infection or previous surgery. This group of patients may experience recurrent meningitis attacks. If the fluid coming from this ear can be collected, diagnosis can be made by examining beta2-transferrin in it. Pneumococcal vaccine should be administered in this group of patients against the possible risk of meningitis. Possible underlying cause can be visualized by performing temporal bone tomography. (some congenital anomalies, destruction of bone tissue, temporal bone fractures). Temporal bone cerebrospinal fluid leakage may be seen after some ear surgeries, skull base surgery, and cerebellopontine angle surgeries. Cerebrospinal fluid leakage from the ear may occur in some types of temporal bone fractures.
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