Chronic ear drainage needs diagnosis

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DEAR DR. GOTT: I have had an ear problem for approximately two years. My ear built up with fluid. A tube was inserted. Now my ear continues to drain a clear fluid, like when your nose runs. When I wake up, it is full of liquid. After turning over, it drains out. I have been to four doctors without any help.

DEAR READER: Several things can cause chronic ear drainage, but without further details, I cannot begin to guess what the cause of yours may be.

You don’t mention if you have any other symptoms. Why did your ear first build up with fluid? Did you have an ear infection? Do you have any loss of hearing? Pain? Is the fluid crystal clear, or is there some cloudiness to it? Is there any blood present or an odor? Which ear does it occur in, or does it affect both? Do you have headaches, dizziness or blurred vision? Do you have any skin disorders or other medical problems? Are you currently taking any medications — prescription, herbal or over-the-counter? Does it occur every day? Several times a day? Does anything make it better or worse? All of these are important questions that need to be answered before a proper diagnosis can be made and treatment provided.

You also don’t mention what type of doctors you have been seeing. I assume that at least one was an ear-nose-and-throat specialist because a tube was inserted at the beginning of your symptoms. Have you seen other ENTs? A neurologist? Internist or general practitioner? Have any of the four physicians done thorough examinations to include blood work and imaging studies, such as a CT scan or MRI of your head and neck?

Because I don’t have the answers to any of these, I can only offer some general information about potential causes. The most common is wax. Earwax, however, is not clear. It is typically yellow or brownish. Another common cause is ear infection. This can be chronic but is often associated with some degree of pain and yellow, pus-like drainage. Some may experience partial or total hearing loss in the affected ear.

Allergies can be another cause. This is often seen with other allergy symptoms, such as nasal congestion and itchy, watery eyes. Allergies to metals, such as those present in earrings, can result in ear drainage not associated with seasonal or environmental allergies. These may present with ear redness, itching, swelling and/or a clear, watery discharge. Skin disorders, such as eczema, that affect the ear canal can also present in a similar manner.

Tumors or cancer near the ear or within it can cause an ear discharge; however, this is rare and often is accompanied by ear pain and hearing loss.

Finally, a CSF (cerebrospinal fluid) leak can be a cause. This, also, is rare and most often occurs because of trauma to the head. It often presents with headaches, dizziness and other distressing symptoms.

As you can see, there are many causes, and the above are just a few. I suggest you seek out the help of an ear-nose-and-throat specialist, perhaps one associated with a teaching hospital or university, for a complete examination and testing. Bring any paperwork from your previous physicians. Be sure to provide a complete medical history to include medications, previous surgeries, illnesses, injuries and more. Also, you will need to give a thorough description of the events preceding and during the beginning of your symptoms.

To provide related information, I am sending you a copy of my Health Report “Ear Infections and Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

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