Ear Discharge Is Silently “Eating Away” Your Hearing!

In our outpatient clinic, we often see patients like this:

Ears have been discharging pus on and off for over a decade, hearing has been getting progressively worse—yet they never took it seriously. Only when they could barely hear did they rush to the hospital. Examination reveals that the eardrum has long been perforated, the middle ear structures have been damaged, and irreversible hearing loss has already occurred.

Many people think, “It’s just a little pus—just wipe it clean,” or “It’s normal to lose hearing as you get older.” But in fact, this “tough-it-out” mindset is quietly robbing you of your hearing.

This brings us to a very common but often overlooked ear disease—chronic suppurative otitis media (CSOM).

What is chronic suppurative otitis media?

Chronic suppurative otitis media is a chronic suppurative inflammation of the middle ear cavity (the space inside the eardrum). The inflammation can involve the mucosa, periosteum, and even erode into the bone. Its main features are tympanic membrane perforation, recurrent discharge (otorrhea), and hearing loss.

It is characterized by three words: long-lasting, recurrent, and insidious—

Long-lasting: Many patients suffer from recurrent episodes for years or even decades.

Recurrent: Symptoms easily flare up after a cold, water entering the ear, fatigue, or when immunity is low.

Insidious: In the early stage, it is often painless and symptomless—just occasional discharge and mild hearing loss, easily mistaken for “excessive internal heat” or “old age,” leading to delayed treatment.

This is not “dampness” or “heat” in the traditional sense—it is a genuine organic lesion.

According to a systematic review published in the Journal of Epidemiology and Global Health in 2025, the global prevalence of CSOM is approximately 3.8%, affecting an estimated 297 million people. Among them, about 62% (184 million) have disabling hearing loss (>25–30 dB).

These signs are signals from your ear:

Recurrent ear discharge (pus), especially after a cold or after water gets in during bathing/swimming

Progressive hearing loss—turning up the TV volume more and more

Frequently asking others to repeat themselves, feeling a stuffy or buzzing sensation in the ear

Turning one ear toward the speaker, often saying “Huh?” or “What did you say?”

How does CSOM “eat away” your hearing?

The damage CSOM causes to hearing is often gradual, happening in three steps.

Step 1: Tympanic membrane perforation – “The door is broken”

The eardrum is the first barrier of the middle ear. Once it is damaged, bacteria can enter freely.

Typical presentation: Recurrent “oozing” (purulent discharge) from the ear. The discharge may be yellow, thick, and sometimes foul-smelling. Symptoms worsen after colds, water exposure, or fatigue.

At this stage, many people still feel no pain and think, “It’s just a little pus.”

Step 2: Ossicular damage – “The precision device is broken”

The ossicles are three tiny bones in the middle ear that form a “sound transmission chain,” carrying sound from the eardrum to the inner ear.

Long-term inflammation can erode, harden, or even fracture the ossicles. Severe infection may also damage the nerve, leading to irreversible sensorineural hearing loss. Studies show that 50–78% of patients with CSOM have some degree of hearing impairment.

Typical presentation: Hearing begins to decline noticeably, feeling like the ear is stuffed with cotton. Early on, this is often mistaken for “fatigue” or “old age.” As it progresses, it begins to affect daily communication.

Step 3: Cholesteatoma formation – “The woodworm” appears

A cholesteatoma is not a tumor, but a growth of epithelial tissue that erodes bone. It acts like a “woodworm,” gradually eating into deeper structures.

This is the most dangerous stage. The “woodworm” can damage the facial nerve (causing facial paralysis) or even spread intracranially, leading to life-threatening complications such as meningitis or brain abscess.

According to the Chinese Clinical Guidelines for the Management of Chronic Otitis Media (2020 Edition), about 10–15% of CSOM patients in China have concurrent cholesteatoma. If not treated promptly, it can lead to severe intracranial complications.

These “habits” are harming your ears

When faced with recurrent ear discharge, many people resort to common but misguided practices.

× Blocking with cotton or tissue (some patients even pour medicinal powder into the ear canal using folk remedies)

Blocking the pus inside the ear canal creates a warm, moist breeding ground for bacteria. Poor drainage worsens the infection and may lead to serious intracranial or extracranial complications.

× Randomly using antibiotic ear drops

Non-standard diagnosis and treatment can cause fungal infections of the ear canal skin, further aggravate bacterial infection of the middle ear, and the two interact, prolonging treatment and reducing efficacy.

× The “tough-it-out” approach

Delaying treatment only allows a minor problem to become a major one—progressing from simple eardrum perforation to ossicular chain destruction, or even cholesteatoma, eventually leading to sensorineural hearing loss that may not be fully reversible even with surgery.

The only correct approach is: seek timely care at a proper medical facility and have a professional evaluation.

Get an otoendoscopy to clearly see the eardrum and middle ear.

Get a hearing test to objectively assess the nature and degree of hearing loss.

Let the doctor develop an individualized treatment plan.

Seeking medical help early not only improves quality of life but also gives you a better chance of preserving your hearing.

Chronic suppurative otitis media is NOT a disease you can just “tough out.”

Every episode of discharge may be quietly eroding your ossicles.

Every time you ignore it, you bring irreversible hearing loss one step closer.

Please stop saying “It’s nothing.”

Please stop stuffing cotton in your ears.

Please stop “toughing it out.”

Hearing is life.

Seek medical help early—protect your hearing.