The Medical Consumer's Advocate

Bleeding from the ears

Q: Is bleeding from the ears normal? My doctor said it was and I wanted another opinion.

A: Bleeding from the ear (bloody otorrhea) is never normal. Why would your doctor say such a thing? Here is a partial list of possible causes of bleeding from the ear:

Trauma... anything from the trivial (scratching your ear canal with the end of a paper clip) to the catastrophic (severe blunt head trauma with skull base fracture).

Otitis externa (swimmer's ear), an excruciatingly painful inflammation of the ear canal skin, can, on occasion, bleed.

Otitis media (middle ear infection), particularly if the infection results in a perforation of the ear drum.

Chronic otitis media is a longstanding infection in the middle ear, usually with a nonhealing perforation.

A tumor in the ear canal or middle ear.

A vascular malformation in the ear canal or middle ear.

This one's a reach, but stay with me here: imagine a severe nose bleed in a person with a perforated ear drum. The blood can travel down the back of the nose, into the Eustachian tube orifice, up the Eustachian tube to the middle ear, then out the perforation and into the ear canal. I've seen it.

Also, don't disregard the possibility that the blood has flowed down from a scalp lesion (or other trauma -- even a gun shot wound!) and only appears to come from the ear canal.

I hope this list helps. Unless you know of an obvious and benign explanation, I recommend you see an ENT to help determine the source of the bleeding.

The Medical Consumer's Advocate

Bleeding from the ears

Q: Is bleeding from the ears normal? My doctor said it was and I wanted another opinion.

A: Bleeding from the ear (bloody otorrhea) is never normal. Why would your doctor say such a thing? Here is a partial list of possible causes of bleeding from the ear:

Trauma... anything from the trivial (scratching your ear canal with the end of a paper clip) to the catastrophic (severe blunt head trauma with skull base fracture).

Otitis externa (swimmer's ear), an excruciatingly painful inflammation of the ear canal skin, can, on occasion, bleed.

Otitis media (middle ear infection), particularly if the infection results in a perforation of the ear drum.

Chronic otitis media is a longstanding infection in the middle ear, usually with a nonhealing perforation.

A tumor in the ear canal or middle ear.

A vascular malformation in the ear canal or middle ear.

This one's a reach, but stay with me here: imagine a severe nose bleed in a person with a perforated ear drum. The blood can travel down the back of the nose, into the Eustachian tube orifice, up the Eustachian tube to the middle ear, then out the perforation and into the ear canal. I've seen it.

Also, don't disregard the possibility that the blood has flowed down from a scalp lesion (or other trauma -- even a gun shot wound!) and only appears to come from the ear canal.

I hope this list helps. Unless you know of an obvious and benign explanation, I recommend you see an ENT to help determine the source of the bleeding.

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