bloody ear discharge
Introduction
Introduction External auditory canal discharge refers to a pathological phenomenon of abnormal fluid accumulation or outflow in the external auditory canal, which is one of the common symptoms of the ear. The discharge can be continuous or intermittent, and can be serous, mucous, purulent, bloody, or mixed, usually with pus and blood secretions, also called bloody ear points. The external auditory canal of the patient was examined by otoscopy, and fluids of various natures were found to flow out.
Cause
Cause
The cause of bloody ear secretions
The ear canal discharge is due to various acute and chronic infections, tumors, trauma and other diseases in the ear canal, middle ear and surrounding tissues, which cause abnormal secretions and lead to bloody ear secretions.
The external auditory canal discharge is mainly caused by diseases of the outer ear and middle ear, and a few are caused by lesions of the inner ear, intracranial and adjacent organs and tissues. It is most common in people with inflammation and allergies. It can also be cerebrospinal fluid, exudate from the ear, and secretions from the fistula that opens into the external auditory canal. External auditory canal discharge is associated with the following diseases:
1. External ear disease: acute otitis externa, external auditory canal eczema, external auditory canal, external ear canal mycosis, and external auditory canal inflammation secondary to external auditory canal cholesteatoma, external auditory canal, and external auditory canal. Benignity of the external auditory canal (such as papilloma) and malignant tumors can also cause external auditory canal discharge.
2, middle ear disease: bullous tympanitis, acute suppurative otitis media tympanic membrane perforation, various types of chronic suppurative otitis media, middle ear tuberculosis, middle ear cancer.
3, other diseases: such as cerebrospinal fluid otorrhea, opening in the external auditory canal and so on.
Examine
an examination
Related inspection
General examination otoscopy of the ear
Examination of bloody ear secretions
According to the nature of the ear canal discharge:
(1) Serous discharge: found in the early stage of external auditory canal eczema, allergic otitis media or acute otitis media.
(2) Mucinous discharge: It is more common in simple type of suppurative otitis media.
(3) purulent discharge: seen in acute otitis externa, deafness; suppurative mumps pus perforated into the external auditory canal, upper tympanic sinus type chronic suppurative otitis media.
(4) Bloody exudate: trauma of the external auditory canal and/or middle ear mucosa, external ear, middle ear tumor, etc.
(5) clear water-like discharge: seen in head trauma, humeral fracture, sacral tumor after radiation, breast sinus or sacral surgery, ear leakage cerebrospinal fluid.
The external auditory canal discharge is mainly caused by diseases of the outer ear and middle ear, and a few are caused by lesions of the inner ear, intracranial and adjacent organs and tissues. It is most common in people with inflammation and allergies. It can also be cerebrospinal fluid, exudate from the ear, and secretions from the fistula that opens into the external auditory canal.
Ask about medical history
Bloody ear secretions, external auditory canal and external auditory canal tend to have earache first, then discharge, earache is severe, persistent, and the ear canal is relieved after the pus out of the external auditory canal; if there is ear itching without earache, mostly External auditory canal eczema; cerebrospinal fluid ear leaks have a history of head trauma or surgery; first ear pain, fever, followed by external auditory canal bleeding, should consider acute suppurative otitis media; intermittent, recurrent or persistent external auditory canal pus accompanied by hearing loss , seen in chronic suppurative otitis media. Middle ear cancer often has a history of chronic suppurative otitis media. Blood is present in the secretions and the deafness is aggravated, accompanied by earache and facial paralysis.
Local examination
Pay attention to the properties, color and smell of the secretions. Serous or purulent secretions mixed with blood, mostly acute suppurative otitis media or external auditory canal fistula; cerebrospinal fluid otorrhea is a continuous, colorless and transparent watery liquid, which may be reddish but not coagulated when mixed with blood; cholesteatoma Sexual otitis media has a small amount of pus but a strange smell; the secretion of tuberculous middle ear mastoiditis has a special odor. At the same time, pay attention to whether there are foreign bodies, sputum plugs, cholesteatoma, new organisms in the external auditory canal, whether the skin is congested, swollen, and whether there is a fistula opening. Whether the tympanic membrane has bullae, perforation, whether there is a tumor in the tympanic cavity, cholesteatoma, whether there is redness and tenderness in the mastoid area.
Laboratory inspection
If suspected middle ear mastoid lesions should be X-ray or CT examination; suspected cerebrospinal fluid otorrhea should check the sugar content of the liquid and perform X-ray examination of the skull base; if new organisms in the middle ear are found, biopsy should be performed early. Purulent secretions should be tested for bacterial culture and drug susceptibility.
Diagnosis
Differential diagnosis
diagnosis:
1. External ear disease: acute otitis externa, external auditory canal eczema, external auditory canal, external ear canal mycosis, and external auditory canal inflammation secondary to external auditory canal cholesteatoma, external auditory canal, and external auditory canal. Benignity of the external auditory canal (such as papilloma) and malignant tumors can also cause external auditory canal discharge.
2. Middle ear disease: bullous tympanitis, acute suppurative otitis media tympanic membrane perforation, various types of chronic suppurative otitis media, middle ear tuberculosis, middle ear cancer.
3. Other diseases: such as cerebrospinal fluid otorrhea, fistula opening in the external auditory canal.
Symptoms of bloody ear secretions that are confusing
Bloody ear secretions should be distinguished from "oily sputum", which is caused by excessive secretion of the parotid gland. The secretion is yellow or dark brown paste or honey-like, often with a genetic predisposition. The pus in the ear refers to the pus in the ear, its color or yellow or cyan, its quality is thick or thin.
