Any fluid which comes out of the ear is referred to as ear discharge or otorrhea. Generally,  it may be simply due to ear wax discharge, it may also be a point of concern of a ruptured eardrum. This is why it is very important to have a qualified ENT specialist to assess your condition. A ruptured eardrum can cause fluids and blood to drain from the ear which needs immediate medical attention.

If you are in Singapore, Dr. Annabelle Leong is a top ENT specialist at The ENT Clinic. She is the only Singaporean who has been awarded the Royal Society of Medicine (RSM) National Temporal Bone Prize for displaying the best surgical skill in-ear dissection in the United Kingdom. In addition, she was awarded a fellowship with the House Ear Institute, Los Angeles, the USA in 2011 and counts over 18 years of experience as an ear specialist.

Getting to know your ear problems is important and ear discharge can occur in both adults and children.

What can be the reason behind your ear discharge?

Although ear wax is a usual cause, some of the other conditions which can cause ear discharge include:

  • Ear infections: Otitis Media or a middle ear infection is a common cause of an ear discharge. When the middle ear is infected by bacteria and viruses, it can cause fluid accumulation behind the eardrum. When there is too much fluid build-up behind the ear drum, then the ear drum can perforate releasing the fluid as ear discharge.
  • Sinusitis and Respiratory Tract infections: Chronic sinusitis and respiratory tract infections can spread across the Eustachian pressure tube which is linked at the back of the nose behind the eardrum. This can cause the eardrum to be infected too. Thus, chronic ENT conditions such as sinusitis, respiratory tract infections, and allergies should be promptly resolved to ease ear infections which can result in ear discharge.
  • Trauma: Injury to the ear or head can cause the eardrum to rupture. This can cause ear discharge and a temporary loss of hearing. In addition, trauma to the ear canal can be caused when a cotton swab is used incorrectly, causing the swab to enter the ear interior and damage it. Sudden changes to atmospheric pressure when traveling in an aircraft or scuba diving can cause the ears to experience trauma and the eardrum rupture in some cases. One should also be careful about exposure to sudden loud sounds and noises. These loud noises, for example during an explosion, can cause the eardrum to rupture causing acoustic trauma.
  • Swimmers Ear: As the name suggests, when one spends a long time in the water, it can cause the ear canal or otitis externa to become infected with bacteria and fungus. When the ear is exposed to too much water, it can cause the skin on the walls of the ear canal to break down, allowing easy entry of bacteria and fungus making it a breeding ground for infection. Swimmers’ ears may not always be due to swimming, but any activity which can break the skin of the ear canal. Worsening of eczema causing skin irritation can also be a possible cause.
  • Insertion of foreign objects: Children are more prone to this condition when foreign objects are inserted causing damage to the ear canal leading to an ear infection.
  • Malignancy: Although it relatively uncommon, ear discharge may also arise from an ear tumour such as squamous cell carcinoma of the ear. Severe infection and necrosis of the ear bone can also occur in conditions such as malignant otitis externa, especially in diabetic patients who may initially present with only mild ear pain or slight discharge. Malignant otitits externa can spread and progress very rapidly, leading to serious life-threatening complications of brain abscess, meningitis, sepsis and total hearing loss.
  • Cholesteatoma: This is an abnormal and extremely destructive growth of skin in the middle ear which usually starts off as a small cyst behind the ear drum. This condition can be present from birth or it can occur due to a complication of chronic ear infections or ruptured eardrum. Many people ignore their painless ear discharge and do not realise that this is a serious condition which can destroy their hearing, cause dizziness and vertigo, severe infection of the surrounding structures such as the brain.

Thus, undergoing an ear evaluation is extremely important to investigate the root cause underlying the ear discharge and initiate treatment accordingly.

When to seek help from an ENT doctor?

It is important to have an ENT evaluation if the ear discharge is yellow, white, smelly or blood-stained. Also, if the ear discharge has not resolved within 5 days and ear discharge is accompanied with a fever, then it is important to seek medical help. If you also have a blocked ear or hearing loss together with your ear discharge, then you should definitely see your top ENT specialist in Singapore much sooner.

How Do You Find Out the Cause of the Ear Discharge?

The ENT specialist will first perform a physical examination to investigate the cause of the yellow discharge. The doctor will check for any damage to the outer ear, ear canal or eardrum. If there are any foreign objects present, then the doctor will remove them and clean/micro suction your ear canal to clear it, using the ENT microscope. Ear discharge samples may also be cultured in a laboratory to find out the causative agent if ear discharge is due to an infection either bacterial or fungal.

How is the Ear Discharge treated?

The kind of treatment for the ear discharge will depend on the underlying condition. If the ear discharge is due to a bacterial ear infection, then antibiotic ear drops will be prescribed, especially if the infection is lasting for more than 3 days.

Underlying allergies, sinusitis, and respiratory tract infections if chronic in nature should be resolved to help in preventing ear discharge. Nasal and sinus conditions often produce lots of mucus secretions to clog up the Eustachian pressure tube that leads to the ear.

If there are foreign objects inserted, then surgery may be needed for its removal. A ruptured eardrum would be closely monitored to see if it would heal on its own, usually within a few weeks. If it is not healing then a surgical procedure called tympanoplasty to repair the eardrum may be needed.