Ear Problems:Health Query

In my weekly health query post I will be discussing some very common ear problems.

Read on. Information is power. Never know whom you will be helping.

 

#1 Health Query

Does my 2-month-old baby have a pin pint hole in front of her Right ear? Do I need to worry?

 
The ear develops from the joining of six tissue heaps known as hillocks of His.
 
When there’s a problem in their fusion, you can have pit-like depressions in front of the pinna. This is most common above the level of the tragus (small projection in the front part of the ear).
 
 

How common is this?

 
It occurs in 5 to 6 babies per 1000.
 
 
One side or both sides?
25%  to  50%  it’s bilateral.
Bilateral has a genetic link.
 
 
What you should watch out for
Infections are  common.
Respond to oral antibiotics and local treatment.
 
 
Recurrent infection  is an indication of surgical resection.
 
 
Incision and drainage  during infections should be avoided. Scarring and fibrosis makes future surgery difficult.
 
 

Isolated pre -auricular sinus infrequently associated  with:

 
  • Hearing loss
  • Renal abnormalities
  • Craniofacial deformities
 
Audiological testing is important to rule out hearing problems. 
 
 
 

Renal USG can be performed if the pre-auricular  sinus is associated  with:

 
  • Other facial dysmorphic features
  • Family history of hearing loss
  • Maternal diabetes during pregnancy
 

 

# Healthy query 2

I have yellowish fluid coming out of my ear.What can it be?

 
 

What are the causes of ear discharge? 

Ear discharge occurs  when   infections in various parts of the ear cause secretions .

 Causes:

*Otitis externa : Infection involving external ear.

Furuncle/boil 

Otomycosis :fungal infection

 

*Acute otitis media
Pus gets trapped behind ear drum and the pressure may cause the drum to rupture  and pus mixed with blood gets released  .

This generally occurs after untreated cold for a period of 5 to 7 days.

Accompanied by fever and earache.
Rupture of ear drum occurs with decrease of pain and pus  with  bloody discharge.

 

 

Chronic otitis media

When  ear infection causes persistent  discharge for more than 12 weeks.Ear may be discharging for years .

This often presents with ear drum perforation   and reduced hearing. .

 

*Otitis media with effusion

Generally  associated with allergic rhinitis ,adenoiditis ,Tonsillitis. In this case a sticky discharge occurs.

 

*CSF Otorrhoea

Following head injury  if the junction between  your ear and brain is breached the brain fluid may leak.

Potentially serious condition with a risk of meningitis .

 
 

Types of ear discharge:

*Watery:CSF Fluid covering  the brain
*Mucoid:Middle ear goblet cells are the source .Indicates ear drum perforation.This is sticky like the goo which comes out of your nose ,when you have a cold.
*Pus:Otitisexterna/furuncle/infected fungal  infection ,squamous type of Chronic otitis  media.
*Pus+mucus:Infected mucus,indicates ear drum perforation  .Chronic otitis media mucosal  type when there occurs ear drum perforation.
*Pus+blood:squamous type of Chronic otitis  media potentially serious and needs urgent management.

 
 

*Pus+mucus+blood.:Chronic otitis media mucosal  type with granulation.
Potentially serious and needs urgent management.

 
 

What are the  important  investigations you should do?

*Otoendoscopy :A  chance for you to Visualize the inside of your own ear and see the problem.Done by a trained ENT surgeon.

 

*Pure tone audiometry: PTA  helps to assess diminished hearing which can occur due to ear discharge.Prolonged discharge gradually erodes the small bones ,responsible for sound transmission .

 

*Tympanometry: Ear drum  problems like thinned drum,perforated drum is diagnosed . You can also detect fluid behind an intact drum.

 

*HRCT temporal bone:This is a computed tomography of your ear bone and helps detect ,how far the disease has progressed .Involvement  of brain can also be assessed

 

 
 

What are the options for treatment for discharging ear? 

Treatment  may be:
*Surgical:Chronic Otitis media squamous type( having cholesteatoma and granulations)
*Medical:Acute otitis media,Otomycosis, furuncle of ear.
*Surgical+Medical:Chronic otitis media

 
 
 

What are the other complaints associated with ear discharge? 

 

*Swelling  behind the ear : post aural abscess
*Partial or complete loss of hearing.

 

Earache: more common in acute otitis media, ear furuncle,fungal ear infection.Less common in chronic otitis media. If earache occurs in Chronic otitis media it’s considered  a dangerous  sign.

 

 

 

*Dizziness

 

*Ringing sound in ear:Tinnitus

 

*Acute and chronic mastoiditis

Infection and inflammation of the Mastoid bone.
*Post aural fistula:Opening in the skin behind the ear connecting with the Mastoid bone.(This occurs in Chronic otitis media eroding the bone .)

 
 

*Accompanying signs such as fever and headache often indicating potential  involvement  of the brain.

  • Meningitis
  • Brain abscess
  • Other intracranial  complications.
 
 

*Facial palsy :Disease can cause involvement of the facial nerve.Deviation of mouth,difficulty closing eye,problem with chewing,eating,blowing ,puffing.

 
 
 

Treatment  depends on the exact cause 

Often ear discharge is a symptom  ignored for long.
Avoidance of the problem will put you at risk of serious complications including, permanent  hearing loss.

 

What other queries do you have about ear? Let me know  

 

 

Disclaimer: Health info is meant for educational purposes only and should not be confused as professional medical advice.

 
 
 
 
 
 

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By Dr.Amrita Basu(MBBS,MS)

I am an ENT surgeon by profession, previously working at a Medical college. I believe the Internet is God's way of providing health and wealth information for all. The important thing is to find the right information.

4 comments

  1. SUch a detailed post. I am thinking I have picked up an ear problem thanks to my 1 yr old. I think I am short of hearing these days. He screams on top of his voice!!!

    1. Hee hee Tina.In this case being short of hearing just might help you sometimes????.But yes ,mommy do pick up germs from the little ones.

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