Revisiting Karnasrava: A Comprehensive Review with Ayurvedic Clinical Insights and Modern ENT Correlation

Abstract

Karnasrava describe in classical Ayurvedic texts as pathological ear discharge, has significant overlap with otorrhoea in modern otology. A comprehensive review unifying Ayurvedic concepts of Karnasrava with modern ENT perspectives is currently lacking. Objectives: To critically review Karnasrava from Ayurvedic and contemporary ENT viewpoints, highlight dosha-specific clinical insights, correlate Ayurvedic pathogenesis with modern otorrhoeal mechanisms, and propose an evidence-based integrative management. Methods: Classical Ayurvedic references from Brihattrayi and Laghutrayi were analysed along with contemporary research from PubMed, Scopus, and ENT textbooks. Literature was categorized under etiopathogenesis, clinical features, diagnostic criteria, and treatment strategies. Correlations were drawn between Ayurvedic descriptions and modern classifications of CSOM. Results: Ayurveda describes Karnasrava as a Dosha-driven disorder with specific discharge patterns, arising from vitiation of Vata-pitta-kapha and Srotodushti. Management includes Shodhana, Panchavalkala decoctions, Dhoopana, Nasya, and Karna-purana. Modern ENT focuses on infection www control, aural cleaning, antibiotics, and surgery for chronic disease. Comparison shows shared emphasis on cleansing, infection reduction, and tissue repair. Conclusion: Karnasrava is a complex condition where Ayurvedic principles and modern ENT approaches complement each other. Integrative protocols combining Ayurveda cleansing and healing with evidence-based biomedical care may enhance outcomes future clinical trial and pharmacological evaluation are recommended to this traditional intervention.