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Feature Article

The discharging ear: an approach to assessment

Nigel DW Biggs

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Abstract

Taking a history is an essential part of the assessment of patients with ear pathology. A significant number of conditions can be diagnosed based simply on this. It is especially important to find out the type of discharge present: purulent or mucoid, clear or blood stained.

Key Points

  • The discharging ear can represent a large variety of conditions that can occur in patients of any age.
  • Taking a history is an essential part of the assessment of patients with ear pathology.
  • Common causes of purulent or mucoid discharge include otitis externa, infected perforation, foreign body or infected cholesteatoma.
  • Clear discharge is an uncommon form of otorrhoea in general practice. Usually the history is indicative of the underlying aetiology.
  • Blood-stained discharge usually causes significant concern to the patient. It has a range of possible causes from more benign pathology such as acute otitis media to more serious concerns such as middle ear or ear canal tumours.
  • Classifying the type of discharge present allows the various common aetiologies to be considered, enabling accurate treatment and/or referral of the patient.

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