H05 Bleeding ear (ICD-10:H92.2)

Introduction

Bleeding ear, also known as otorrhagia, refers to the presence of blood coming from the ear canal. It can be caused by various factors, including trauma, infection, or underlying medical conditions^[1]. The aim of this guide is to provide a comprehensive overview of the symptoms, causes, diagnostic steps, possible interventions, and lifestyle interventions for bleeding ear.

Codes

• ICPC-2 Code: H05 Bleeding ear
• ICD-10 Code: H92.2 Otorrhagia^[4]

Symptoms

• Ear pain: Patients may experience pain or discomfort in the affected ear^[2].
• Blood discharge: Blood may be present in the ear canal or on the outer ear^[1].
• Hearing loss: Some individuals may notice a decrease in their hearing ability^[3].
• Dizziness: Patients may feel lightheaded or experience vertigo^[5].
• Tinnitus: Ringing or buzzing sounds in the ear may be present^[6].

Causes

• Trauma: Injury to the ear, such as a blow to the head or insertion of foreign objects, can cause bleeding^[7].
• Infection: Ear infections, such as otitis media or otitis externa, can lead to bleeding^[4].
• Ruptured eardrum: A tear or hole in the eardrum can result in bleeding^[9].
• Foreign body: Presence of a foreign object in the ear can cause irritation and bleeding^[10].
• Earwax impaction: Build-up of earwax can lead to pressure and bleeding^[8].

Diagnostic Steps

Medical History

• Gather information about the patient’s symptoms, including the duration and severity of bleeding^[1].
• Inquire about any recent trauma or injury to the ear^[7].
• Ask about any previous ear infections or surgeries^[4].
• Determine if the patient has a history of earwax impaction or foreign body insertion.

Physical Examination

• Inspect the ear canal and outer ear for signs of bleeding, discharge, or trauma^[1].
• Assess the patient’s hearing ability using a tuning fork or audiometry^[3].
• Check for any signs of infection, such as redness or swelling^[4].
• Evaluate the patient’s balance and coordination to rule out any underlying vestibular issues^[5].

Laboratory Tests

• Complete blood count (CBC): Assess for signs of infection or abnormal bleeding^[1].
• Coagulation profile: Evaluate the patient’s clotting ability^[1].
• Culture and sensitivity: Collect a sample of any discharge for laboratory analysis to identify the presence of bacteria or fungi^[4].

Diagnostic Imaging

• Computed tomography (CT) scan: Provide detailed images of the ear structures to identify any abnormalities or sources of bleeding^[1].
• Magnetic resonance imaging (MRI): Used to assess the soft tissues of the ear and surrounding structures^[1].
• X-ray: May be performed to rule out any fractures or foreign bodies in the ear^[1].

Other Tests

• Otoscopy: Visual examination of the ear canal and eardrum using an otoscope^[1].
• Tympanometry: Measures the movement of the eardrum in response to changes in air pressure^[1].
• Audiometry: Tests the patient’s hearing ability and identifies any hearing loss^[3].

Follow-up and Patient Education

• Schedule a follow-up appointment to monitor the patient’s progress and response to treatment^[1].
• Provide education on proper ear hygiene and the prevention of future bleeding episodes^[1].
• Discuss the importance of seeking medical attention if symptoms worsen or persist^[1].

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Bleeding Ear:

1. Antibiotic ear drops (e.g., Ciprofloxacin, Neomycin, Polymyxin B):
   • Cost: $10-$30 per bottle.
   • Contraindications: Hypersensitivity to the medication.
   • Side effects: Local irritation, itching, or rash.
   • Severe side effects: Allergic reactions, hearing loss.
   • Drug interactions: None reported.
   • Warning: Use as directed and complete the full course of treatment.
2. Corticosteroid ear drops (e.g., Dexamethasone, Hydrocortisone):
   • Cost: $10-$30 per bottle.
   • Contraindications: Hypersensitivity to the medication.
   • Side effects: Local irritation, burning sensation.
   • Severe side effects: Allergic reactions, perforation of the eardrum.
   • Drug interactions: None reported.
   • Warning: Use as directed and avoid prolonged use.
3. Pain relievers (e.g., Acetaminophen, Ibuprofen):
   • Cost: $5-$15 per bottle.
   • Contraindications: Allergy to the medication, history of gastrointestinal bleeding.
   • Side effects: Upset stomach, headache.
   • Severe side effects: Liver damage, gastrointestinal bleeding.
   • Drug interactions: Warfarin, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs).
   • Warning: Follow the recommended dosage and avoid exceeding the maximum daily dose.
4. Antifungal ear drops (e.g., Clotrimazole, Miconazole):
   • Cost: $10-$30 per bottle.
   • Contraindications: Hypersensitivity to the medication.
   • Side effects: Local irritation, itching.
   • Severe side effects: Allergic reactions, worsening of symptoms.
   • Drug interactions: None reported.
   • Warning: Use as directed and complete the full course of treatment.
5. Vasoconstrictor ear drops (e.g., Phenylephrine):
   • Cost: $10-$20 per bottle.
   • Contraindications: Hypersensitivity to the medication, uncontrolled high blood pressure.
   • Side effects: Local irritation, burning sensation.
   • Severe side effects: Allergic reactions, increased blood pressure.
   • Drug interactions: None reported.
   • Warning: Use as directed and avoid prolonged use.

Alternative Drugs:

• Antibiotic oral medication (e.g., Amoxicillin, Cephalexin): Used for severe or recurrent infections. Cost: $10-$50 per course.
• Antihistamine (e.g., Loratadine, Diphenhydramine): May be used if allergies are contributing to the bleeding. Cost: $5-$20 per bottle.
• Antiviral medication (e.g., Acyclovir, Valacyclovir): Prescribed for viral infections, such as herpes zoster oticus. Cost: $10-$50 per course.
• Anticoagulant medication (e.g., Warfarin, Apixaban): Used if bleeding is related to a clotting disorder. Cost: Varies depending on the specific medication.

Surgical Procedures:

• Myringotomy: A small incision is made in the eardrum to drain fluid or blood. Cost: $1,000-$3,000.
• Tympanoplasty: Surgical repair of a perforated eardrum. Cost: $3,000-$7,000.
• Ear tube placement: Small tubes are inserted into the eardrums to prevent fluid accumulation and reduce the risk of bleeding. Cost: $2,000-$4,000.

Alternative Interventions

• Acupuncture: May help improve blood flow and reduce pain. Cost: $60-$120 per session.
• Chelation therapy: Controversial treatment involving the administration of chelating agents to remove heavy metals from the body. Cost: $75-$150 per session.
• Hyperbaric oxygen therapy: Involves breathing pure oxygen in a pressurized chamber to increase oxygen delivery to tissues. Cost: $200-$300 per session.
• Herbal supplements: Some herbs, such as garlic and ginkgo biloba, may have potential benefits for improving circulation. Cost: Varies depending on the specific supplement.
• Homeopathic remedies: Certain homeopathic remedies, such as Arnica montana or Calendula officinalis, may be used to promote healing and reduce bleeding. Cost: Varies depending on the specific remedy.

Lifestyle Interventions

• Avoiding trauma: Encourage patients to take precautions to prevent injury to the ear, such as wearing protective headgear during sports or avoiding the use of cotton swabs.
• Maintaining ear hygiene: Instruct patients on proper ear cleaning techniques and the importance of avoiding excessive earwax removal.
• Avoiding exposure to loud noises: Advise patients to protect their ears from loud noises to prevent damage to the ear structures.
• Managing stress: Stress can exacerbate symptoms, so encourage patients to engage in stress-reducing activities, such as exercise, meditation, or counseling.
• Maintaining a healthy lifestyle: Encourage patients to eat a balanced diet, exercise regularly, and get enough sleep to support overall health and immune function.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – H05 Bleeding ear (ICD-10:H92.2)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Bleeding ear effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Bleeding ear. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. CK Birla Hospital. (n.d.). Ear Bleeding Causes, Treatment & Diagnosis. Retrieved from https://www.ckbhospital.com/blogs/ear-bleeding-causes-and-treatment/
2. Ayu Health. (n.d.). Ear Bleeding: Causes, Diagnosis, And Treatment. Retrieved from https://ayu.health/blog/ear-bleeding-causes-diagnosis-and-treatment/
3. Harley Street ENT. (n.d.). Ear Bleeding: Understanding the Causes, Remedies and Concerns. Retrieved from https://www.harleystreetent.com/blog/ear-bleeding-the-causes-remedies-and-concerns
4. MedicalNewsToday. (2017, September 29). Ear bleeding: Causes and when to see a doctor. Retrieved from https://www.medicalnewstoday.com/articles/320237
5. G Chee ENT Specialist Clinic Singapore. (n.d.). Common Ear Symptoms. Retrieved from https://www.gcheeent.com/common-ear-symptoms/
6. Cleveland Clinic. (2021, July 14). Ear Injuries and Trauma. Retrieved from https://my.clevelandclinic.org/health/diseases/17574-ear-injuries-and-trauma
7. The Pharmaceutical Journal. (2019, January 30). Managing common ear problems: discharge, ache and dizziness. Retrieved from https://pharmaceutical-journal.com/article/ld/managing-common-ear-problems-discharge-ache-and-dizziness
8. Mayo Clinic. (2021, February 11). Ruptured eardrum (perforated eardrum) – Symptoms & causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
9. WebMD. (n.d.). Why Is My Ear Bleeding? Retrieved from https://www.webmd.com/cold-and-flu/ear-infection/ear-bleeding-causes
10. MedicineNet. (n.d.). Foreign Body in the Ear Types, Symptoms, Treatment, Removal. Retrieved from https://www.medicinenet.com/objects_or_insects_in_ear/article.htm