A primary care approach to the discharging ear.

Background: 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.

Objective: 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.

Discussion: 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.