Otorrhea means drainage of liquid from the ear. Otorrhea results from external ear canal pathology or middle ear disease with tympanic membrane perforation.
●Differential diagnosis
The table provides a differential diagnosis for otorrhea in children. The history and physical examination will differentiate among most causes of otorrhea in children.
●Common conditions
The majority of children with otorrhea have bacterial otitis externa or acute otitis media (AOM) with perforation of the tympanic membrane.
●Life-threatening conditions
Patients who are ill appearing or have otorrhea after head trauma require aggressive efforts to diagnose and treat potential life-threatening causes of otorrhea (basilar skull fracture, necrotizing otitis externa, infectious complications of AOM).
●Diagnostic approach
The diagnostic approach to the evaluation of otorrhea in children is summarized in the algorithms.
●Specialist referral or consultation
Once a working diagnosis is established, prompt consultation with a pediatric ear, nose, and throat specialist is warranted for life-threatening conditions (eg, cerebral spinal fluid [CSF] otorrhea, mastoiditis or other infectious complications of AOM, necrotizing otitis externa, or neoplasm) and those that require biopsy for definitive diagnosis.
