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Discharging Ear

  

A range of features help differentiate the causes of ear discharges.


Assessment

Consider causes:

  • otitis externa – mild/moderate/severe; bacterial or fungal
  • otitis media with perforation
  • cholesteatoma
  • necrotising otitis externa
Management
  • GP to examine ears and attempt to visualise tympanic membrane
  • consider swab
  • drops and/or antibiotics, see British National Formulary, section 12.1
Referral Threshold
  • failure to resolve e.g. four weeks
  • non-healing perforation
  • if aural toilet is required
  • if there is severe otitis externa, speak to the ENT doctor on call at UHCW to request an appointment at the daily ENT Emergency Clinic
  • necrotising otitis externa requires ENT assessment (significant pain in an elderly diabetic, particularly bad at night)
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