Thanks for writing to H.C.M. for your query.
I have gone through clinical history regarding ear discharge
and mild to moderate pain in ear. As you said that that you have been operated for perforation in ear drum about 5 years back. From last 1 year you are having off and on ear discharge and pain. By your clinical history few possibilities for pain and discharge comes in mind-
(1) Recurrence of past pathology.- Commonly found in cases of cholesteatoma
of ear were recurrence is quite common.
(2) As a complication of recurrent upper respiratory tract
(3) perforation of grafted ear drum.
Before reconstructive surgery
you are advice for these investigations.-
(1) C.T.scan of paranasal sinuses- to rule out recurrent upper respiratory tract infection.
(2) C.T.scan of ear (H.R.C.T.).
(3) Culture and sensitivity of ear discharge.
(4) Blood - CBC, blood sugar F & P.P.
(5) Urine Routine & Microscopic.
By thorough clinical examination and their co-relation with above investigations one can reach to correct diagnosis which is than accordingly plan for treatment.