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Dr. Lakshmi Ponnathpur, MS – ENT MBBS | Phone 📞 080 2663 1108 (Online & in-person appointment can be booked online or by call) Consultant ENT Surgeon | Skin, Cosmetic & ENT Care Center, Bangalore, India | Registration No: 23754 Karnataka Medical Council, 1985
Generally the foul smelling your discharge, the commonest reason is a condition called Cholesteatoma. Cholesteatoma is equal to skin in the wrong place in the middle ear leading to local destruction of the tissues and a foul smelling your discharge sometimes it can also happen due to a neglected left alone old foreign body such as a cotton ball in the ear is a second really infected so coming to Cholesteatoma. This is the commonest cause for a foul swelling ear discharge it happens in a condition called Unsafe type of CSOM. CSOM is Chronic Suppurative Otitis media. So there’s a defect in the tympanic membrane in the Arctic upper part or in the corner called a posterior marginal perforation and the dead skin keeps growing inwards in the form of a socket and all the dead skin and the Keratin accumulates which is secondly invaded by bacteria leading to foul smelling discharge. The Cholesteatoma matrix also has a destructive properties because of it secretes the enzymes which the causes destruction of the local ossicles and other tissues and it keeps on invading slowly other tissues leading to a foul smelly discharge. The culprit bacteria is a dreadful bacteria called pseudomonas aeroginosa which leads to a green discharge from the ear. So whenever there is a foul smelling ear discharge we have to do a oral toileting that is cleaning up of the ear canal and look for debris such as a cholesterol flake or a Cholesteatoma plaque in the posterior superior quadrant if there is any perforation or if there is any attic defect. We have to do a thorough examination sometimes under microscopy or with a auto endoscope then we’ll be able to arrive at a correct diagnosis where to take the pus for culture and sensitivity test to see which bacteria is growing then if the Cholesteatoma is suspected we have to do other investigations such as a high resolution CT scan of the temporal bone to see where all the Cholesteatoma is spreading and what are the tissues which it has destroyed, whether it has destroyed the facial nerve or the lateral semicircular canal and then we can plan the surgery surgery is mandatory whenever Cholesteatoma is there. So we do a surgery called mastoidectomy it’s generally a wide open cavity mastoidectomy where we remove all the disease tissue and lower the facial ridge making it as a wide cavity so that the self-cleansing mechanism is established and disease does not accumulate inside and grow inwards. Later on we also reconstruct the hearing mechanism by the Tympanoplasty operation.
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