Definition: Persistent discharge from the middle ear through a perforated tympanic membrane lasting >6weeks.

Demographics: Children and adolescents <15yo.

Risk Factors: see below

Aetiology

• Bacterial infection following perforation of the TM due to:
  • (Recurrent) AOM.
  • Placement of a ventilation tube.
  • Traumatic perforation.

Common bacteria: Pseudomonas aeruginosa, Staph aureus, Klebsiella pneumoniae and diptheroids.

Pathophysiology

Infection secondary to translocation of bacteria from the external ear canal into the middle ear through a perforated TM.

Clinical Features

• Painless

• Recurrent otorrhoea (usually odourless; mucoid or serous).

• Conductive hearing loss.

• Fever is unusual and indicative of complications.

  

Management