February 24, 2021
Often we ignore the problems that we don’t hear. Ironically the problems of ear are often addressed when we don’t hear much! Not much is spoken or heard about ear discharge. Much to our liberal attitude we often shun what displeases the eye and what can be more hideous than to see pus dribbling from our ears.
According to medical literature the commonest cause of hearing loss are diseases associated with ear discharge, albeit our pouring ears make us deaf too. The usual issue is a hole in the ear drum, this causes a constant low grade infection which in turn causes production of mucus which is seen as painless discharge, keeping the patient from seeking timely medical help.
Only when the discharge is frequent and embarrassing it is at that time the patient seeks medical help, it may sometimes be associated with hearing loss. Such type of ear infection goes by the term Chronic Suppurative Otitis Media or simply known as CSOM. Majority of the cases the treatment is very simple, initially the condition can be managed medically and thereafter surgically for permanent cure.
They are of two types, Tubotympanic or CSOM TTD and Atticoantral CSOM AAD. The former (CSOM TTD) is a relatively safer type characterized by ear drum hole, copious discharge which is often associated with cold. These cases are managed by planned surgery wherein the disease is cleared and a new ear drum is placed. Sometimes the set tiny bones inside the ear maybe eroded which may require reconstruction. In most of the cases surgeries are successful with dry and good hearing ear. A patient with such a disease is encouraged to undergo surgery as it’d not only give him good hearing but improve his quality of life.
CSOM AAD is rather a sinister disease which is characterized by continuous scanty ear discharge which maybe foul smelling. Since the discharge is not profuse so these individuals often don’t suffer from social embarrassment but since it is foul smelling it can be offensive for them. Unlike its counterpart this disease is dangerous, it forms infective foci which erodes the underlying and can present with complications like giddiness, facial deformity and brain involvement. It is a clinical diagnosis which later can be confirmed on CT scan. In almost all probabilities urgent surgery is warranted. Here the surgery is more radical, the focus is on disease clearance rather than hearing preservation (main intention being to avoid other serious complications). But, recent advances in surgical technique have shown promising results in restoration of satisfactory hearing. Whatever the reason might be, it is of paramount importance to undergo surgery by the earliest to avoid the various complications.
The surgery is usually performed under general anaesthesia where the patient has no recollection of the procedure. The procedure requires admission for 1-3 days based on patient recovery after surgery. A stitch in time saves nine is an old proverb. The same applies to ear discharge too. Seeking medical or surgical help on time would help ensure a better hearing.