Ear discharge and hearing loss in an elderly woman

Chronic otitis media is a recurring inflammatory condition in which the tympanic membrane is not intact (perforated), allowing pus to travel from the middle ear to the ear canal in the presence of active infection. 2 The cause is multifactorial, although there are known risk factors, including an acute attack of otitis media, upper respiratory tract infections, and eustachian tube dysfunction. 2 Eustachian tube dysfunction leads to a negative pressure in the middle ear resulting in retraction of the tympanic membrane, and this can cause retraction pockets that increase the risk of an ear infection developing. Many affected patients have a history of ear disease in childhood and the condition is more prevalent in people from lower socioeconomic groups. 3 (4) When dealing with patients with hearing difficulties it is important that clinicians take simple measures to break the communication barrier and help patients understand the conversation, such as choosing a location where background noise is minimal and speaking clearly and in short sentences.