Educational information, not medical advice. This article is written to help you understand common ear and hearing issues. It is not a substitute for professional diagnosis or treatment. If your symptoms are severe, sudden, or persistent, please consult a qualified doctor or audiologist. For urgent symptoms (sudden hearing loss, bleeding from the ear, severe pain with dizziness, or a head injury), seek medical care the same day.
Ear discharge that keeps coming back or lasts more than two weeks is often chronic suppurative otitis media (CSOM), a long-standing infection with a hole in the eardrum. It needs an ENT, not just drops from a chemist. Treatment can dry the ear, protect hearing and, if needed, repair the eardrum.
The direct answer
Ear discharge that persists for more than a couple of weeks, or keeps returning, is commonly chronic suppurative otitis media (CSOM): a long-lasting middle-ear infection with a perforated eardrum. It does not usually clear up by itself, and left untreated it can damage hearing and, rarely, cause serious complications. An ENT should examine it, and treatment is usually effective.
What CSOM is
In CSOM the eardrum has a persistent hole, and infection in the middle ear drains through it as a discharge that may be watery, pus-like or foul-smelling. It often begins after an untreated or repeated middle-ear infection, and is more common in children and in people with repeated colds, and where water gets into the ear. See middle ear infection and perforated eardrum.
Symptoms
- Discharge from the ear, on and off or continuous, sometimes with a smell.
- Reduced hearing on that side.
- A feeling of fullness, and sometimes ringing.
- Pain is often mild or absent in the chronic stage, which is why it is easy to ignore.
Why you should not ignore it
- Hearing loss: repeated infection and the eardrum hole reduce hearing, often a conductive loss, and can involve the middle-ear bones.
- Serious complications (uncommon): spread of infection to the bone behind the ear (mastoiditis), facial weakness, dizziness, or, rarely, infection around the brain.
- Warning signs to go the same day: severe pain, swelling behind the ear, facial weakness, high fever, severe headache, stiff neck or confusion.
Treatment
- Ear cleaning (aural toilet): careful cleaning of the discharge by a doctor.
- Prescribed ear drops: the right drops for the right stage, as chosen by an ENT. Avoid random drops and never use home remedies such as oil, as they can worsen infection.
- Oral antibiotics in some cases.
- Keeping the ear dry: avoid water in the ear when bathing, swimming or washing hair, as advised by your doctor.
- Surgery: repair of the eardrum (tympanoplasty), sometimes with mastoid surgery, once the infection is controlled, to close the hole and protect or improve hearing.
Hearing after CSOM
Once the ear is dry and any surgery is done, an audiogram shows how much hearing remains. Some people regain much of their hearing after repair. If hearing is still reduced, a hearing aid can help, and the audiologist will choose a style that suits an ear with a healed or repaired eardrum. Read degrees of hearing loss and how to choose the right hearing aid.
What to do now
- See an ENT. Do not put drops, oil or home remedies in a discharging ear.
- Keep the ear dry until you have been examined.
- Get your hearing tested. A free hearing test records your baseline, and our audiologists work closely with ENT surgeons.
This article is general information and does not replace medical advice.
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Frequently asked questions
What is CSOM?
Chronic suppurative otitis media is a long-lasting middle-ear infection with a hole in the eardrum, through which discharge drains on and off. It often starts after an untreated or repeated middle-ear infection.
When is ear discharge a sign of CSOM?
When discharge lasts more than a couple of weeks or keeps coming back, often with reduced hearing on that side. Pain is often mild or absent at this stage, which is why it is easy to ignore.
Can CSOM cause hearing loss?
Yes. Repeated infection and the hole in the eardrum reduce hearing, usually as a conductive loss. Uncommonly, infection can spread to the bone behind the ear or cause facial weakness or dizziness.
How is CSOM treated?
With careful ear cleaning by a doctor, the right prescribed drops for the stage, sometimes oral antibiotics, keeping the ear dry, and surgery to repair the eardrum (tympanoplasty) once the infection is controlled.
Can I use a hearing aid after CSOM?
Yes, if hearing is still reduced once the ear is dry and any surgery is done. The audiologist will choose a style that suits an ear with a healed or repaired eardrum. Some people regain much of their hearing after repair.
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