How Should I Evaluate a Draining Ear?

Judith S. Lynch, MS, MA, APRN-BC

June 28, 2012

Trauma to the External Ear Canal

Common traumatic causes of otorrhea include^[3]:

Use of a cotton-tipped swab or other device to remove cerumen from the EAC;
Recent ear cleaning by a healthcare provider, causing bleeding in the EAC (incidence, 10%);
Foreign body lodged in the EAC;
Blunt trauma to ear due to domestic violence, motor vehicle accident, or sports accident;
Recent head injury;
Perforated tympanic membrane; and
Recent flying or diving, causing barotrauma.

A thorough ear examination is necessary in every case of bleeding from the ear. If the tympanic membrane cannot be visualized, immediate evaluation by an ear-nose-throat (ENT) specialist is mandatory to assess for mobility and perforation. Patients should be warned that cotton-tipped swabs can be very dangerous to ear health and should never be used in the ear canal.

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