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{{Otorrhea}}
{{Otorrhea}}
{{CMG}}
{{CMG}}
==Overview==
==[[Otorrhea overview|Overview]]==
Ear discharge caused by an irritation or inflamed tissue within the mastoid, ear canal or middle ear.


==Pathophysiology==
==[[Otorrhea historical perspective|Historical Perspective]]==
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.


== Differential Diagnosis of Causes==
==[[Otorrhea classification|Classification]]==


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
==[[Otorrhea pathophysiology|Pathophysiology]]==


*[[Cerebrospinal fluid]] otorrhea
==[[Otorrhea causes|Causes]]==
*[[Cholesteatoma]]
*Foreign body
*Malignant otitis externa
*[[Mastoiditis]]
*Otitis media with perforated [[tympanic membrane]]
*Swimmers ear ([[Otitis externa]])


==Diagnosis==
==[[Otorrhea differential diagnosis|Differentiating Otorrhea from other Diseases]]==
===Physical examination technique===
To determine the cause of the otorrhea, it is necessary to clean the ear, preferably via suction. In the event that otorrhea is present, '''do not utilize ear lavage due to the potential risk of injury. Cerebrospinal fluid otorrhea should always be measured in the event there was face or head trauma/surgery.'''


==Complications==
==[[Otorrhea epidemiology and demographics|Epidemiology and Demographics]]==
Instead of the infection and eardrum perforation resolving, however, drainage from the middle ear can become a chronic condition. As long as there is active middle ear infection, the eardrum will not heal. The World Health Organization defines Chronic Serous Otitis Media (CSOM) as 'a stage of ear disease in which there is chronic infection of the middle ear cleft, a non-intact tympanic membrane (i.e. perforated eardrum) and discharge (otorrhoea), for at least the preceding two weeks' (WHO 1998). (Notice WHO's use of the term "serous" to denote a bacterial process, whereas the same term is generally used by ear physicians in the United States to denote simple fluid collection within the middle ear behind an intact eardrum. "Chronic otitis media" is the term used by most ear physicians worldwide to describe a chronically infected middle ear with eardrum perforation.)


=== Ear Nose and Throat ===
==[[Otorrhea risk factors|Risk Factors]]==
*Cleaning the ear thoroughly with magnification
:*If no tymanic membrane, then the source is the external ear canal


=== MRI and CT ===
==[[Otorrhea natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*CT of temporal bones for cholesteatoma, mastoiditis and CSF otorrhea


=== Other Diagnostic Studies ===
==Diagnosis==
*CSF otorrhea:
[[Otorrhea history and symptoms|History and Symptoms]] | [[Otorrhea physical examination|Physical Examination]] | [[Otorrhea laboratory findings|Laboratory Findings]] |  | [[Otorrhea CT|CT]] |  | [[Otorrhea MRI|MRI]] | [[Otorrhea other imaging findings|Other Imaging Findings]] | [[Otorrhea other diagnostic studies|Other Diagnostic Studies]]
:*beta 2 trasferrin to identify CSF


== Treatment ==
==Treatment==
Foreign bodies can be removed with alligator forcieps 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.
[[Otorrhea medical therapy|Medical Therapy]] | [[Otorrhea surgery|Surgery]] | [[Otorrhea primary prevention|Primary Prevention]] | [[Otorrhea secondary prevention|Secondary Prevention]] | [[Otorrhea cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Otorrhea future or investigational therapies|Future or Investigational Therapies]]
== Pharmacotherapy ==


=== Acute Pharmacotherapies ===
== Case Studies ==
*Antibiotic drops
[[Otorrhea case study one|Case #1]]
*Topical antifungal


==References==
==References==

Revision as of 16:13, 26 February 2013

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

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Otorrhea from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | | CT | | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

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