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Getting smelly green discharge from ear. CT scan showed mildly thickened tympanic membrane. Any idea?

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ENT Specialist
Practicing since : 1991
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My wife observed a green discharge from her left ear which had a foul smell. We took a CT Temporal bone scan from diagnostics. Findings from the CT says "1. MILDLY THICKENED LEFT TYMPANIC MEMBRANE WITH MINIMAL MUCOSAL THICKENING ALONG THE POSTERIOR WALL OF EAC, 2. MINIMAL SOFT TISSUE DENSITY IN THE LEFT PRUSSAK'S SPACE". What should we do ?
Posted Tue, 16 Apr 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. With a green discharge, it is best to get an ear swab done for bacterial culture and antibiotic sensitivity to rule out Psedomonas infection, especially if she is diabetic.

2. Get her ear cleaned and examined under a microscope. The suction and clearance must also be applied to the Left Prussack's Space to see if there is any retraction pocket or any cholesteatoma. The thickened ear drum may be a myringitis. The thickening along the posterior wall of the EAC may be granulation tissue, which signifies that the infection has spread to the temporal bone.

3. Get her hearing tests (Pure Tone Audiogram-PTA) and an Impedance Audiogram (Tympanogram) done.

4. If the above tests are within normal limits, it is only an external ear infection. It will settle with appropriate antibiotics.

5. If it is a severe otitis externa or cholesteatoma, the treatment may require surgery.

6. Dizziness due to the ear is usually rotatory vertigo (spinning). Imbalance may be due to the infection or other factors. Does she have any history of nasal or sinus problems?

7. You may also share the ct Scan Images here.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

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