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Suggest Remedy For Recurring Ear Discharge After Mastoidectomy

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Posted on Fri, 30 Jan 2015
Question: Hello Doctor, This pertains to my son 11 yrs old.Initially sometime in Jan'13, he had some watery discharge from right year which gradually became a sort of green yellowish semi liquid discharge though earlier general physician and later on ENT specialist tried to treat it through Antibiotic and Ear drops.In Nov'13, first time it was diagnosed as unsafe CSOM. In Dec'13 he had Bondy's Mastoidectomy + Meatoplasty surgery in right year for cholestetoma removal.In April'14 he had meatoplasty for meatal stenosis as there was narrowing down of ear canal opening.In Oct'14 again there was stenosis and he was given two steroid (kenokort) injection 10ml with one month interval.However from last almost two and a half month, he is again having similar semi liquid discharge as he was having before Mastoidectomy in Dec'13.In last three months, his ear has been cleaned through suction pump 5-6 times.Because of discharge, doctor has stopped steroid injection.Right now he is taking 60mg allegra tablet twice a day but discharge continues.He also has eardrum perforation as on date existing right from Mastoidectomy stage.I am attaching his case history with all reports/prescriptions for latest diagnosis/expert advise and further course of action as we are worried for continous and regular discharge and tendency on his part for keloid formation past surgery.
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Answered by Dr. Abubakar Siddiqh (58 minutes later)
Brief Answer:
residual or recurrence- needs regular life time follow-up

Detailed Answer:

Hi,


I had gone through your question and understand your concerns that your son having persistent ear discharge.


As per your clinical details,it appears to be residual or recurrent cholesteatoma, secondary to chronic adenoiditis or tonsillitis (source of infection) or water per ear.

Solutions-

1. Find out the source of infection- tonsil or adenoid infection (correct them).

2. Residual or recurrent cholesteatoma (as per ct temporal bone - all middle ear and inner ear-are free from cholesteatoma) doesn't require radical surgery. Enodscopic/microscopic suction with regular follow-up and systemic (inject able antibiotic for active infection.

3. Meatal stenosis ( needs ventilation for mastoid bowl, surgery needed (meatoplasty).

4. keloid- hyalase will solve the problem.

These are few options I suggest in this case. You might discuss about it with your treating doctor.

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Abubakar Siddiqh

ENT Specialist

Practicing since :1994

Answered : 2038 Questions

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Suggest Remedy For Recurring Ear Discharge After Mastoidectomy

Brief Answer: residual or recurrence- needs regular life time follow-up Detailed Answer: Hi, I had gone through your question and understand your concerns that your son having persistent ear discharge. As per your clinical details,it appears to be residual or recurrent cholesteatoma, secondary to chronic adenoiditis or tonsillitis (source of infection) or water per ear. Solutions- 1. Find out the source of infection- tonsil or adenoid infection (correct them). 2. Residual or recurrent cholesteatoma (as per ct temporal bone - all middle ear and inner ear-are free from cholesteatoma) doesn't require radical surgery. Enodscopic/microscopic suction with regular follow-up and systemic (inject able antibiotic for active infection. 3. Meatal stenosis ( needs ventilation for mastoid bowl, surgery needed (meatoplasty). 4. keloid- hyalase will solve the problem. These are few options I suggest in this case. You might discuss about it with your treating doctor. Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.