Features

Most Common Symptoms
- Otorrhoea (discharge from ear)
- Itchy ear
- Hearing loss

Diagnosis

- Otorrhoea (discharge from ear) with perforation of tympanic membrane
- Perforated tympanic membrane

Other Aggravating Factors

- Contaminated water entering the ear
- Upper respiratory tract infection (cold)
- Stopping breast feeding early
- Reflux
- Passive cigarette smoke exposure
- Overcrowding
- Poor hygiene
- Poor nutrition

Preventative Measures

- Continue breast feeding until 12 weeks
- Avoiding smoking around babies and children
- Avoid prop-feeding, with the baby lying flat and the bottle “propped up”
- Vaccination including Prevnar
- Early treatment of ear infection to avoid chronic discharge.
- Avoid contaminated water entering ear

Treatment

- Betadine ear toilets
- Antibiotics – topical fluoroquinolones eg. Ciloxan eardrops
- Culture of middle ear fluid
- Myringoplasty to close perforation (once ear is dry)

Complications

- Hearing loss
- Granulation tissue and polyps
- Cholesteatoma
- Chronic mastoiditis
- Meningitis
- Intracranial abscess

Indications for referral

- Hearing loss
- Discharge that fails to resolve despite adequate medical treatment
- Non-healing perforation
- Any of the listed complications