In the treatment of the draining ear, the first priority is to diagnose the cause and location of the drainage. Often, this is impossible to accomplish without the use of a microscope and equipment (suction, cerumen loops, etc.) capable of cleaning debris out of the ear. If there is a systemic condition causing the disorder, it must be treated. After making the appropriate diagnosis, good local care is imperative. The ear must be cleaned of all debris, but in so doing, the practitioner must avoid causing additional trauma to the already irritated ear canal.
In treating individuals with otorrhea, a number of issues should be kept in mind. Whereas drainage does not always completely stop five to seven days after treatment, there should be some effect by that time. If there is no effect within one week, or if the condition gets better and then returns within two weeks, an alternate diagnosis and treatment plan should be considered. In particular, this group of patients is at risk for serious complications and should be followed closely until the symptoms resolve and an adequate search for other disorders can be performed.
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