Bloody otorrhea

Introduction In addition to trauma and inflammation, bloody ear canal secretions should also pay attention to the possibility of ear tumors. The former has a history of trauma and ear pain, fever and other inflammatory manifestations, it is not difficult to identify; while the latter may only be manifested as ear canal bloody secretions, gradually appearing hearing loss, ear pain, facial paralysis, dizziness, difficulty opening mouth, headache and other symptoms. Therefore, those with the above symptoms should go to the hospital as soon as possible. If there are new organisms in the ear canal, pathological examination should be done to confirm the diagnosis. Most bloody ear leaks are related to trauma, but be alert to hemangioma or middle ear cancer. Especially in middle ear cancer, blood in the pus, its pus has stench, or severe earache, headache, it is ominous. Pathological examination should be performed on the suspicious tissue in the external auditory canal or middle ear to determine the diagnosis and treatment.

Cause

The cause of bloody ear leaks:

In addition to trauma and inflammation, bloody ear canal secretions should also pay attention to the possibility of ear tumors.

The former has a history of trauma and ear pain, fever and other inflammatory manifestations, it is not difficult to identify; while the latter may only be manifested as ear canal bloody secretions, gradually appearing hearing loss, ear pain, facial paralysis, dizziness, difficulty opening mouth, headache and other symptoms.

Therefore, those with the above symptoms should go to the hospital as soon as possible. If there are new organisms in the ear canal, pathological examination should be done to confirm the diagnosis.

an examination

Related inspection

Ear, nose, throat swab bacterial culture Otolaryngology CT examination

1. Ask about medical history:

External auditory canal and external auditory canal often have earache first, then there is discharge, ear pain is severe, persistent, ear pain in the external auditory canal is relieved after pus out; if there is ear itching without earache, mostly external ear 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 bloody ear leaks with hearing loss, then seen in chronic suppuration Sexual otitis media.

Middle ear cancer often has a history of chronic suppurative otitis media, with bloody ear leaks and increased deafness, accompanied by earache and facial paralysis.

2, check the body:

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.

3. 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.

Differential diagnosis

Bloody ear leaks are confusing symptoms

Ear leak: Some non-purulent fluid flows out of the external auditory canal, medically known as "ear leak". If there is often a pale yellow viscous oil in the external auditory canal, this is due to excessive secretion of sebaceous glands in the external auditory canal, also known as seborrheic otitis externa.

Ear discharge: refers to the accumulation of fluid in the external auditory canal or from the external auditory canal, is one of the common symptoms of ear disease. Occasionally it can be caused by lesions in adjacent tissues.

Ear pus: ear pus is also known as ear leak, a common symptom of ear disease. When the ear is pus, attention should be paid to the nature, quantity and odor of the pus for identification. In the case of external auditory canal, there may be watery secretions.

Ear canal pus: When there is inflammation in the external auditory canal or middle ear, the phenomenon of pus in the ear canal can occur. Traditional Chinese medicine treats diseases with perforation of eardrum and pus in the ear as the main symptoms, collectively referred to as pus.

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