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What is otorrhea?
Otorrhea is drainage that comes out of your ear. Sometimes, people refer to otorrhea as “runny ears” or “watery ears.”
Most commonly, otorrhea is the result of a ruptured eardrum from an ear infection. When there’s a hole in your eardrum, the fluid in your middle ear drains out into your ear canal. But other conditions can cause otorrhea too, including swimmer’s ear, an unknown object stuck in your ear or, less commonly, head trauma.
Is otorrhea an infection?
Although the most common reason for otorrhea is infection, having otorrhea doesn’t necessarily mean you have one.
In most cases, otorrhea is a symptom of a middle ear infection (otitis media) or an outer ear infection/inflammation (otitis externa). But otorrhea can also occur if you have an unknown object stuck in your ear. Less commonly, the condition can develop following a major head injury.
Who does otorrhea affect?
Otorrhea is most common in children, but it affects adults too. In children, the condition is usually associated with ear infections. Trauma or injury often causes otorrhea in adults.
Otorrhea is also the presentation of middle ear infection after ear tube placement. It occurs in up to 17% of cases. If your child has ear tubes, you may be advised to use antibiotic drops to stop the drainage. If the drainage doesn't stop after a course of antibiotic drops, your child's healthcare provider will usually have them come in to investigate further.
Children or adults who have otorrhea due to otitis externa or swimmer’s ear can reduce the risk of otorrhea by wearing specialized ear plugs when in the water. Or you can coat a cotton ball in petroleum jelly and place it in your ear canal.
What are the types of otorrhea?
There are five types of otorrhea:
- Purulent (contains pus).
- Serous (contains serum, a protein-rich liquid in your blood).
- Bloody (contains blood).
- Mucoid (contains mucus).
- Clear (thin and watery).
How common is otorrhea?
Otorrhea is very common. It’s associated with several harmless (benign) and serious conditions. Most commonly, it’s a condition that develops due to ear infections.
Symptoms and Causes
What are the symptoms of otorrhea?
The main symptom of otorrhea is drainage from your ear. This drainage may be odorless or it may smell foul. It can be thin or thick in consistency and clear, yellowish or green in color.
Other common otorrhea symptoms include:
Some people develop more serious symptoms, including:
- Redness (erythema) of the skin around your ear.
- Hearing loss.
- Cranial nerve dysfunction, such as difficulty swallowing, speaking or seeing.
These people may have also had a history of recent head trauma.
People who have diabetes or a compromised immune system have a higher risk for complications. Be sure to call your healthcare provider right away if you develop any of the symptoms listed above.
What causes otorrhea?
Common otorrhea causes include:
- Ruptured eardrum.
- Middle ear infections (acute and chronic).
- Outer ear infections, such as swimmer’s ear or fungal yeast infections of your ear canal.
- Unknown object stuck in your ear.
Less common otorrhea causes include:
- An abnormal skin growth behind your eardrum (cholesteatoma).
- Fracture at the base of your skull.
- Cancer of your ear canal.
- Malignant (necrotizing) external otitis (a severe infection of your external auditory canal and skull base).
Is otorrhea contagious?
Otorrhea itself isn’t contagious nor are ear infections in general. But if you have a cold as the result of an ear infection, it can spread to other people through coughing or sneezing.
Diagnosis and Tests
How is otorrhea diagnosed?
Your healthcare provider will perform a physical examination, which generally includes:
- Checking your vital signs to see if you have a fever.
- Inspecting your ear canal to check for drainage, infection or a ruptured eardrum.
- Feeling around your ear, jaw and neck for swelling or other abnormalities.
- Examining the skin around your ear for redness and inflammation.
What tests can help diagnose otorrhea?
In many cases, a physical examination is all that’s necessary to diagnose otorrhea. But your healthcare provider may also recommend some tests to confirm your diagnosis, including:
- Audiometry: This test measures the range and sensitivity of your sense of hearing.
- CT scan: This imaging test can tell your healthcare provider if infection has spread beyond your middle ear.
- MRI: If you’ve sustained head trauma, your provider may use magnetic resonance imaging to detect cerebrospinal fluid (CSF) leaks.
- Cranial nerve examination: If you’ve had recent head trauma — or if you have difficulty seeing, swallowing or speaking — your provider will test your cranial nerves for proper function.
- Culture: Your provider may sample the drainage and see if any bacteria or fungi grow from it.
Management and Treatment
How do you treat otorrhea?
Otorrhea treatment focuses on the cause of ear drainage. For example, if otorrhea is the result of a bacterial infection in your middle ear, your healthcare provider will likely prescribe antibiotics. Your provider will likely treat outer ear infections with antibiotic ear drops.
If you have a ruptured eardrum, it may heal on its own in a few weeks. But some people need surgery (tympanoplasty) to close the hole.
If the cause isn’t immediately determined, your provider may refer you to a specialist. People who have chronic ear infections may need to see an otolaryngologist (ENT). If head trauma is a suspected cause, your provider will likely refer you to a neurosurgeon for further evaluation and treatment.
Can I prevent otorrhea?
As most otorrhea causes are unavoidable, you can’t completely prevent the condition. But in people who have repeated episodes of swimmer’s ear, using specialized ear plugs when swimming or bathing can help reduce the risk of ear drainage.
Outlook / Prognosis
What can I expect if I have otorrhea?
Most of the time, otorrhea treatment is straightforward. Your healthcare provider will likely prescribe oral antibiotics or antibiotic ear drops to clear up any infection.
If you or your child has chronic ear infections, your provider may refer you to an ENT for more testing.
When otorrhea is a side effect of a recent head injury, your provider will immediately refer you to a neurosurgeon to determine next steps. This is an emergency that needs immediate attention.
How long does otorrhea last?
Otorrhea may be short-term (acute) or long-term (chronic). How long it lasts depends on the cause.
When should I see my healthcare provider?
If you have ear drainage that lasts for more than three days, you should call your healthcare provider to schedule an appointment. You should also schedule an appointment right away if you’re having pain, fevers or redness around your ear or neck. Otorrhea is a symptom of several different conditions, both benign and serious. Prompt diagnosis is important.
When should I go to the ER?
If you’ve developed ear drainage following a recent head trauma or injury, call 911 or head to your nearest emergency room right away. You should also seek immediate care if you have trouble swallowing, speaking or seeing.
What questions should I ask my healthcare provider?
Some questions you may want to ask your healthcare provider include:
- What’s causing the ear drainage?
- Do I have an ear infection? If so, what type?
- What medications should I take?
- Do I need to see a specialist?
- Will I need additional testing?
- Do I need emergency treatment?
A note from Cleveland Clinic
Otorrhea refers to ear drainage, and it’s caused by many different things. Most of the time, it’s the result of an ear infection or ruptured eardrum. It usually goes away in a few days with treatment. In some instances though, otorrhea can mean you have another serious health issue. So it’s best to see your healthcare provider at the first sign of trouble.
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