Questionnaire/history: Ear discharge persisting for more than 2 weeks, without ear pain or fever? Hearing loss in the affected ear? Affects on daily activities? Tinnitus? Sensation of pressure in the ear?

Past medical history? - Acute otitis media (AOM)? - Ear trauma? - Glue ear and grommet insertion? - Allergy, atopy? - Upper respiratory tract infection? Current medication? Drug allergies? Examination: Tympanic membrane perforation and/or middle ear inflammation? Management: Referred for ENT assessment Advised: - Secondary care treatment is likely to involve antibiotics and steroids (usually topical) and intensive cleaning of the affected ear - In case of an eardrum perforation, hearing loss will usually return when the perforation heals, but a hearing test may be done in secondary care - To keep the affected ear dry