What are the signs and symptoms of chronic otitis media with tympanic membrane perforation and recurrent otorrhea?

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From the FDA Drug Label

Chronic Suppurative Otitis Media with perforated tympanic membranes The recommended dosage regimen for the treatment of chronic suppurative otitis media with perforated tympanic membranes in patients 12 years and older is: Ten drops (0.5 mL, 1. 5 mg ofloxacin) instilled into the affected ear twice daily for fourteen days.

The signs and symptoms of chronic otitis media with tympanic membrane perforation and recurrent otorrhea are not directly stated in the provided drug label. However, based on the context of Chronic Suppurative Otitis Media with perforated tympanic membranes, it can be inferred that the condition may involve:

  • Otorrhea (discharge from the ear)
  • Perforated tympanic membranes (a hole in the eardrum)
  • Suppurative symptoms (pus or discharge)
  • Chronic symptoms (long-term or persistent) 1

From the Research

Chronic otitis media with tympanic membrane perforation and recurrent otorrhea typically presents with persistent or intermittent ear drainage, hearing loss, and occasional ear pain, with the hallmark symptom being otorrhea (ear discharge) that may be clear, purulent, or blood-tinged, and often has a foul odor during active infection. The symptoms of this condition can be summarized as follows:

  • Persistent or intermittent ear drainage (otorrhea)
  • Hearing loss, which can be conductive and fluctuates with the amount of discharge present
  • Occasional ear pain
  • Tinnitus
  • Sensation of ear fullness or pressure
  • Visible tympanic membrane perforation on otoscopic examination, appearing as a hole or tear in the eardrum
  • Inflamed and edematous middle ear mucosa during active infection
  • Potential for vertigo if the infection extends to the inner ear

The size and location of the perforation can affect the degree of hearing loss, with larger perforations or those involving the posterior half of the tympanic membrane potentially leading to greater hearing loss 2. Patients with this condition often have a history of recurrent acute otitis media, previous ear surgeries, or childhood ear infections, and the condition can be exacerbated by water exposure, upper respiratory infections, or manipulation of the ear canal.

If left untreated, complications may include cholesteatoma formation, ossicular chain erosion with worsening hearing loss, or spread of infection to surrounding structures. Treatment typically involves keeping the ear dry, topical antibiotic drops during active infection (such as ciprofloxacin/dexamethasone drops, 4 drops twice daily for 7-10 days), and consideration of surgical repair (tympanoplasty) for persistent perforations, as supported by recent studies on the effectiveness of topical antibiotics in achieving resolution of ear discharge 3.

References

Research

Correlation of Tympanic Membrane Perforation with Hearing Loss and Its Parameters in Chronic Otitis Media: An Analytical Study.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2020

Research

Topical antibiotics for chronic suppurative otitis media.

The Cochrane database of systematic reviews, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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