Otorrhagia is the externalization of red blood through the ear canal. Its diagnosis is thus easy. It occurs due to wounds, bruises, cuts, or tissue damage in the ear. It is commonly seen in the setting of petrous temporal bone fractures or soft tissue injuries to the external or middle ear.
• The main characteristic sign of otorrhagia is blood in or around the orifice of the ear that has originated from within the ear.
• If an eardrum puncture occurs, it may exhibit ear pain, hearing loss, ringing sound, vertigo, nausea, and vomiting.
• An ear infection may lead to symptoms including a sensation of pain and pressure in the ear, fever, vertigo, headaches, inflammation in lymph nodes, difficulties in sleeping, and maintaining body balance.
• Barotrauma-related otorrhagia may show symptoms such as a persistent sensation of pain and pressure in the ear, vertigo, dizziness, and a ringing sound.
• If a foreign object is lodged in the ear canal, the individual may experience pain, fluid oozing out, hearing loss, and dizziness.
• Ear cancer manifests with ear pain, ear pressure, facial numbness, pain in facial muscles, blurred vision, ringing sound, headaches, and swelling in the lymph nodes.
• Otorrhagia associated with head trauma or a concussion will be accompanied by headaches, dizziness, nausea, vomiting, feeling hazy, increased sensitivity to light and sound, blurry vision, trouble maintaining balance, and confusion.
Depending on the point of origin of the bleed, the causes of otorrhagia can vary. For example, bleeding from the outer ear can be due to a skin injury, while bleeding from the inner ear might result from more serious conditions.
• Superficial skin injuries
Minor injuries to the skin of the external ear, including cuts, wounds, and bruises, can cause bleeding.This can occur due to physical trauma by sharp or blunt objects or accidents.
• Foreign object in the ear
Young children frequently insert toys, candy, and other small items in their ears while playing with them. If the object is lodged in the ear canal for a considerable time and refuses to come out, it can cause discomfort and ear bleeding.
• Ear infection
Infections such as otitis media, otitis externa, and otitis interna, can cause pus accumulation in the ear that harms the eardrum and leads to otorrhagia.
• Eardrum rupture
A tear or perforation in the tympanic membrane, commonly known as the eardrum, can occur due to any of the causes.The broken tissue caused by the rupture leads to otorrhagia.
• Barotrauma: Barometric changes are sudden differences in air pressure occurring in cases of flights or diving. It is the ear pain, and popping sensation experienced during any abrupt change in altitude.This is known as barotrauma and can also lead to eardrum rupture that will result in otorrhagia.
• Head trauma
Severe trauma to the head can cause otorrhagia, wherein the blood could have originated from the inner ear or possibly the brain. This is extremely serious and needs immediate medical intervention since it could be skull damage or a concussion.
Otoscopy is a diagnostic tool used in otorrhagia to find the source of the bleed. An otoscope is inserted into the ear canal to find a foreign object, eardrum tear, and debris that may have caused otorrhagia.
If these tests do not return with conclusive results, imaging scans such as computed tomography (CT) scans or X-rays might be required.
• If an infection causes the ear to bleed, antibiotic eardrops or oral antibiotics are prescribed as treatment.
• If the infection is chronic, surgical tube insertion is done to drain accumulated fluid to prevent it from getting infected.
• A ruptured eardrum is treated by a reparative surgery known as tympanoplasty.
• Treatment for foreign body-induced otorrhagia is the removal of the object using a pair of tweezers.
• Medications such as analgesics (ibuprofen, paracetamol, naproxen) are used to treat the pain associated with these conditions.
Ayurvedic Perspective –
In Ayurvedic point of view, Otorrhagia could be correlated with Karansrava.
The management of karnasrava depends on its cause. Internal medications along with karnadhavana (cleaning of ear canal), karnadhoopana (fumigation of ear canal), karnapoorana (retention of suitable oil in ear), gandusha (gargling with medicines) etc. are provided.
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