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Q. I have occasional smelly ear discharge after CSOM surgery. Kindly help.

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 29, 2020

Hello doctor,

I have ear discharge for the past two weeks with thick and bad smell pus. I have operated CSOM (chronic suppurative otitis media) of the right ear four years ago. I feel occasional discharge and go to hospitals, but due to COVID-19, I did not go for the past six months. I am using Ciplox D but not useful. Should I take Augmentin 625? Should I use Otovin ear drops?

#

Hi,

Welcome to icliniq.com.

Thanks for providing a detailed description of the problem in concern. You have developed an acute infection of the eardrum, and that is why there is severe discharge.

You can consider the following treatment advice.

Take a tablet containing a combination of Cefpodoxime 200 mg plus Potassium clavulanate 125 mg one tablet two times a day for five days. This is an antibiotic and can create loose motions in a few. If you happen to develop loose motions, you can start probiotics one tablet in the morning and evening for the next one week.

Tablet Zerodol P (Aceclofenac and Paracetamol) one tablet two times a day after food 12 hours apart for five days (this is an anti-inflammatory and pain killer)

Please stop using earbuds at any cost as it introduces new infection into the ear canal and can be the reason for a severe folliculitis. You can end up traumatizing the ear canal and eardrum, since cleaning your ear on your own is entirely a blind technique. The wax, which usually falls off on its own due to jaw movements, gets further pushed inside the ear and can cause trouble.

Take tablet Sinarest in the morning and evening after food for one week. Keep the ears dry.

I hope this helps.

Thank you doctor,

I took tablets as you proscribed but not much benefits. Pus (fluid) is not coming outside but it is there inside. If I use my finger in ear it still smells. My ear is blocked with a heavy head (not painful) and loud ringing as usual. I feel hearing loss due to blocking ear. I am attaching my CT scan report. Please prescribe tablets and ear drops if needed.

#

Hi,

Welcome back to icliniq.com.

I had a look at the CT scan as well (attachment removed to protect patient identity). I suggest you get the ear examined under a microscope or endoscope as this will be required for in-depth assessment and giving appropriate antibiotics to tackle the problem effectively.

Repeated use of antibiotics in such a scenario is not recommended as it will not treat the problem from the root level. Even if there happens to be any sort of benefit, it will be short term and will not fetch long term relief from the problems you are currently having.

Let me know what the examination under microscope reveals as if there is evidence of cholesteatoma clinically, then you will require a repeat surgery to clear this bone erosive property that cholesteatoma has got.

I hope this helps.


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