Long-Standing (Chronic) Ear Discharge: Causes, Assessment, and Treatment
A Hampshire ENT Clinics patient guide
Persistent or recurrent ear discharge (otorrhoea) is not normal and should always be assessed by an ENT specialist. If an ear has been leaking fluid or pus for weeks or months, this suggests underlying middle-ear disease that may require targeted treatment to prevent long-term hearing damage.
At Hampshire ENT Clinics, we regularly assess and manage chronic discharging ears using a structured, evidence-based approach.
What Is Chronic Ear Discharge?
Chronic ear discharge refers to ongoing or recurrent fluid or pus from the ear, typically lasting longer than 6 weeks. It is often associated with a perforated eardrum or deeper middle-ear pathology.
Discharge may be:
Continuous or intermittent
Foul-smelling
Associated with hearing loss or discomfort
Common Causes of Long-Standing Ear Discharge
1. Chronic Suppurative Otitis Media (CSOM)
A long-term middle-ear infection associated with a persistent eardrum perforation.
2. Cholesteatoma
An abnormal growth of skin within the middle ear that can cause chronic discharge and progressive damage to hearing bones and surrounding structures. This requires urgent ENT assessment.
3. Persistent Eardrum Perforation
Following infection, grommets, or trauma, a perforation may fail to heal and allow repeated infection.
4. Chronic Otitis Externa (Less Common)
Inflammation of the ear canal can occasionally mimic middle-ear discharge but is usually painful and itchy.
Symptoms That Should Prompt ENT Review
Ear discharge lasting more than 2–3 weeks
Foul-smelling or persistent discharge
Associated hearing loss
Recurrent infections despite drops or antibiotics
Dizziness, pain, or facial weakness (urgent review required)
How Are Chronic Discharging Ears Assessed?
Assessment at Hampshire ENT Clinics typically includes:
Microscopic ear examination
Hearing tests (audiometry)
CT scanning of the temporal bone if cholesteatoma is suspected
Swabs only if clinically indicated
This helps identify the exact cause and plan appropriate treatment.
Treatment Options
1. Medical Management
Initial treatment may include:
Careful microsuction
Targeted antibiotic or steroid ear drops
Advice on keeping the ear dry
Oral antibiotics are rarely effective alone.
2. Surgery
Surgery may be required when:
Infection persists despite optimal medical treatment
There is a cholesteatoma
A persistent perforation causes recurrent discharge
Procedures may include:
Tympanoplasty (repair of the eardrum)
Mastoid surgery to remove disease and create a dry, safe ear
Why Early Treatment Matters
Untreated chronic ear discharge can lead to:
Progressive hearing loss
Recurrent infections
Damage to middle-ear bones
Rare but serious complications involving balance or facial nerve function
Frequently Asked Questions (FAQs)
Is chronic ear discharge dangerous?
It can be. While some causes are straightforward, others—particularly cholesteatoma—can cause serious long-term damage if untreated.
Why does my ear keep discharging even with drops?
Drops may temporarily suppress infection, but underlying problems such as a perforation or cholesteatoma often require definitive treatment.
Is it safe to get the ear wet?
No. Keeping the ear dry is essential until assessed, as water can worsen infection.
Will my hearing improve once the discharge stops?
Often yes, particularly if hearing loss is due to infection or a perforation that can be repaired.
Do I need a scan?
CT scanning is used selectively, especially if cholesteatoma is suspected or surgery is being considered.
Can chronic ear discharge affect balance or the face?
Rarely, but this is why prompt assessment is important if symptoms worsen or new neurological symptoms appear.
Where can I be assessed?
Assessment and treatment are available at Hampshire ENT Clinics, with consultant-led care across Portsmouth, Winchester, Salisbury, and the wider Hampshire region.
Expert Care for Chronic Ear Problems
Long-standing ear discharge is a sign of underlying disease and should not be ignored. Accurate diagnosis and timely treatment can restore hearing, stop discharge, and prevent complications.
📞 If your ear has been discharging for weeks or months, contact Hampshire ENT Clinics to arrange an expert assessment.