Otorrhea

Abnormal fluid discharge from the external auditory canal, consisting of serous, mucous, purulent, bloody, or cerebrospinal fluid, originating from the external or middle ear.

Causes

• External ear causes

  • Otitis externa

  • Eczema of the external auditory canal

  • Fungal otitis externa (otomycosis)

  • Foreign body with secondary infection

  • External auditory canal trauma

• Middle ear causes

  • Acute otitis media with tympanic membrane perforation

  • Chronic suppurative otitis media

  • Eustachian tube dysfunction with secondary infection

• Cholesteatoma

  • Acquired cholesteatoma

  • Congenital cholesteatoma

• Traumatic causes

  • Ear canal laceration

  • Temporal bone fracture

  • Barotrauma

  • Blood (hemorrhagic otorrhea)

  • Cerebrospinal fluid (CSF) leak following skull base trauma or surgery

• Postoperative causes

  • Ear surgery

  • Tympanostomy tube drainage

  • Mastoidectomy-related discharge

• Other infectious causes

  • Herpes zoster oticus (Ramsay Hunt syndrome)

  • Tuberculous otitis media (rare)

  • Necrotizing (malignant) otitis externa

• Neoplasms involving the external or middle ear