A primary care approach to the discharging ear

Otorrhoea is a common presentation in both primary care and emergency settings, with a broad range of differential diagnoses that can make accurate assessment and management challenging for the primary care practitioner.

This article describes a systematic approach to the assessment of otorrhoea, outlines common causes and their first principles of management in the primary care setting, and provides recommendations for when specialist referral is indicated.

A clear clinical assessment and targeted investigations are essential in the identification and initial management of otorrhoea. Many causes of a discharging ear can be managed in the primary care setting; however, it is also important to recognise circumstances in which escalation is required to a specialist otolaryngology service.