The problem of the ‘draining ear’

"Draining ear" is a common occurrence in the Philippines. Often, Filipinos just think of it as a "simple cold in the ear." It is because of this lack of understanding that the condition is often left unattended and untreated.

What many don’t know is that it is an ear infection which may lead to a wide range of complications from non-life threatening yet significant hearing loss, to a severe brain infection.

"Unfortunately, majority of the population treats this condition as a momentary inconvenience, something akin to the common cold," said Dr. Benjamin S.A. Campomanes, chairman of St. Luke’s Medical Center’s Department of Otorhinolaryngology (ENT).

Campomanes recently led his team of St. Luke’s ENT specialists, Drs. Joel Romualdez, Raymond Belmonte and Joanne de Ramos, at the Philippine College of Physicians’ Media Health Forum held at Annabel’s Restaurant.

"What they do not realize is that draining ear is likely a symptom of something potentially more serious like a tear somewhere inside the ear that may be infected and lead to other complications," he said.

The condition manifests itself and is aggravated by the common cold. The ear is connected to the nose by he eustachian tube.

When a person becomes infected with a cold, pressure is created in the eustachian tube. Increased pressure from this tube creates perforations in the soft tympanic membrane (or the ear drums). This results in the infection leaking to the middle ear. The resulting condition is what otolaryngologists call Chronic Suppurative Otitis Media (CSOM).

It is estimated that a total of 65 million to 330 million people around the world have CSOM, and when untreated, between 39 million and 200 million (or 60 percent) will suffer varied levels of hearing impairment.

In the local scene, Romualdez said national surveys have yet to be done. However, a study conducted in 2002 at a major government hospital revealed that 30 percent of their emergency cases and 60 percent of those with operated ears suffered from this condition.

"There is a prevalence of this potentially debilitating condition in this country, that is why it is important for all to be aware of the risks and to arrest the situation," Romualdez said.

De Ramos cited common behavior and social patterns that make Filipinos susceptible to "draining ear" and CSOM.

"First is that majority of our urban population is not affluent and lives in congested areas. We also spend a lot of time in confined areas like public transportation and malls where we can easily catch colds and infections. Since CSOM is aggravated by mucous discharge, they become prone to the condition once a cold sets in," she said.

De Ramos also mentioned that Filipinos are naturally resilient and ignore supposedly minor medical conditions, especially when these pose little hindrance to their work and social life.

"Most of the cases we encounter are ear conditions that have become severely inflamed, or worse, those where damage to the ear and surrounding tissues has become irreversible," she said.

"To an extent, a draining ear should be treated as a signal from the body to act and seek treatment immediately," Belmonte said.

"This symptom of CSOM should be looked into by an ENT specialist immediately. The risks may seem simple but what people do not realize is that a severely inflamed ear can lead to a range of debilitating conditions from simple itchiness, profuse liquid discharge, vertigo, facial paralysis and brain abscess to meningitis."