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Types, Causes, Treatment, and Prevention

Ear pain, or earache, can originate from any of the three parts of the ear. Among the three sections in the ear, a person could have outer ear pain, middle ear pain, or inner ear pain. Ear pain can also originate from a problem close to the ear, such as from sinusitis, temporomandibular joint syndrome, or a dental infection.

How ear pain feels (aching, sharp, dull, etc.), its intensity, its location, and other symptoms you are experiencing (e.g., fever, dizziness) can give your doctor a place to begin when working to make a diagnosis.

Most often, your doctor can achieve this without any testing, though some cases may call for imaging and blood tests in order to rule out more serious causes of ear pain, such as mastoiditis or an ear tumor.

The treatment plan your doctor creates for your ear pain will depend on your underlying diagnosis and may entail a combination of therapies.

Alexandra Gordon / Verywell

Causes

Due to the multiple possible causes of ear pain, it’s easiest to consider primary diagnoses (which originate within the ear) versus secondary diagnoses (which originate outside the ear) separately.

Primary Causes

Conditions that often cause ear pain and originate within the ear include the following:

Otitis Media

Otitis media describes a middle ear infection in which fluid and inflamed tissue builds up in the middle ear space—the area between your eardrum (tympanic membrane) and the oval window of your inner ear.

Besides a moderate to severe aching pain felt deep in the ear, a person with otitis media may report several days of nasal congestion and/or a cough preceding the ear pain. Sometimes, a fever may occur.

If the eardrum ruptures as a result of the pressure buildup, purulent (containing pus) ear drainage may result.

Otitis Media With Effusion

Otitis media with effusion (OME) describes the presence of middle ear fluid without signs of infection. In other words, there is fluid buildup without tissue inflammation. Overall, the ear pain of OME is generally mild and associated with a feeling of ear fullness and/or decreased hearing.

Typically, OME follows acute otitis media, but it may also occur as a result of barotrauma (injury caused by air or water pressure) or allergy. Rarely, OME occurs as a result of tumor blockage of the eustachian tube—a tunnel that connects the middle ear to the upper throat and back of the nose.

External Otitis (Swimmer’s Ear)

External otitis—an infection of the ear canal—causes a feeling of ear fullness, itchiness, and significant ear pain when the earlobe is pulled. Yellowish or clear-colored ear discharge may also occur, along with decreased hearing and swelling of the ear canal.

The reason external otitis is commonly called “swimmer’s ear” is because it often develops when water gets trapped in the ear canal. Another common culprit behind external otitis involves the frequent use of cotton swabs. Inserting them into the ear can create small cuts in the ear canal that serve as a breeding ground for bacteria.

A severe complication of external otitis is necrotizing (malignant) external otitis in which the ear canal infection spreads to the base of the skull. This condition is more common in older people with diabetes mellitus.

Perforated Eardrum

A perforated eardrum is a hole, or tear, in the eardrum. The eardrum is a delicate structure within the ear and can be torn easily by an injury, a change in pressure, or explosively loud noise. It is also commonly associated with middle ear infections (otitis media).

Aside from sharp ear pain, people who have a perforated eardrum may experience sudden hearing loss, fluid leaking from the ear, or hear a ringing or buzzing sound in the ear.

Earwax Blockage

The purpose of earwax (cerumen) is to protect your ear canal from water, bacteria, and injury. Sometimes though, too much earwax is produced or the wax gets pushed back too deep into the ear canal (why doctors recommend not using cotton swabs to clean out your ears).

If an earwax blockage occurs, ear discomfort—often reported as a full or congested sensation—may occur. Problems hearing and ringing in the ear may also result from earwax blockage.

Remember

Removing earwax with cotton swabs, fingers, or other objects can make your ear blockage worse and damage the eardrum.

Eustachian Tube Blockage

The eustachian tube is a narrow tunnel that connects your upper throat to your middle ear. It regulates the air pressure in and drains excess fluid from your middle ear. If the eustachian tube becomes blocked, often as a result of allergy, infection, or a rapid altitude change, the following symptoms may occur:

• Ear pain
• Ringing or popping in the ears
• Dizziness
• Hearing loss

Ear Skin Problems

Sometimes ear pain originates from the skin of the ear.

Three related conditions include:

• Dermatitis of the ear, which causes itching, flaking, and swelling of the skin of the ear canal, may result from an allergic reaction (contact dermatitis) or as a result of an underlying skin problem (i.e., seborrheic dermatitis or psoriasis).
• Periauricular cellulitis (infected skin on the ear) results in a red, hot, and extremely tender ear. A fever may also be present.
• Herpes zoster oticus (“shingles of the ear”) causes severe ear pain along with a vesicular rash (tense, fluid-filled sacs). In rare instances, facial paralysis may occur along with the rash and ear pain in what’s known as Ramsay Hunt syndrome.

Perichondritis

Perichondritis arises from an infection of your ear cartilage, resulting in pain, swelling, and redness over the skin. Fever may also be present and sometimes an abscess (collection of pus) forms. Without treatment, perichondritis can lead to ear deformity (called cauliflower ear) as the infection cuts off blood supply to the cartilage, thereby destroying it.

Perichronditis is most likely to occur in people with certain autoimmune conditions, such as granulomatosis with polyangiitis, and those who experience trauma to the ear cartilage (e.g., upper ear piercing, a burn, or harsh contact from sports).

Labyrinthitis

Labyrinthitis is inflammation of a structure in the inner ear called the labyrinth. The labyrinth normally helps you to keep your balance. Labyrinthitis can also involve problems with the cranial nerve, or auditory nerve, within the inner ear.

People with labyrinthitis may experience dizziness, nausea, vomiting, or ringing in the ear. It can involve ear pain, but is rarely painful.

Meniere’s Disease

Meniere’s disease is caused by excess fluid buildup in the inner ear, although the precise “why” behind this fluid retention is unknown. In addition to the classic triad of symptoms—vertigo, ringing in the ears, and hearing loss—some people with Meniere’s disease report ear pain or pressure.

Tumor

Although not common, a cancerous or noncancerous tumor may be the source behind a person’s ear pain. For example, nasopharyngeal cancer (a type of head and neck cancer) may cause ear fullness, along with hearing loss, ringing in the ears, and recurrent ear infections.

Two examples of noncancerous tumors or growths that may develop in the ear and cause pain include:

• Cholesteatoma: A benign skin growth that forms in the middle ear
• Acoustic neuroma: A benign inner ear tumor that develops on the vestibular nerve (eighth cranial nerve).

Secondary Causes

These conditions may cause ear pain, thought they originate outside of the ear.

Sinusitis

Sinusitis refers to infection or inflammation of the sinuses, which are hollow spaces located behind your nose, between your eyes, and within your cheekbones and lower forehead. Sinusitis may cause a variety of symptoms, such as:

• Ear pressure, discomfort, or fullness
• Fever
• Nasal congestion and discharge
• Tooth pain
• Headache

Most cases of sinusitis are caused by a viral illness or allergy; only a small percentage of cases are due to a bacterial infection.

Dental Problems

Dental problems, such as a cracked tooth, decayed tooth, or tooth abscess, may refer pain to the ear. Usually, the pain is worsened by hot or cold stimuli or biting or eating.

Temporomandibular Joint (TMJ) Disorder

Your temporomandibular joint (TMJ) connects your lower jaw to the temporal bone of your skull. Arthritis or erosion of the joint or stress/overuse of the surrounding muscles may cause TMJ disorder.

The pain of TMJ disorder is often described as a constant and dull jaw joint pain that worsens with opening or closing the mouth. Headaches and tenderness around the ear canal are also common.

Giant Cell Arteritis

Giant cell arteritis (GCA) refers to inflammation of the branches of the external carotid artery, a large artery located in your neck. This inflammation may cause pain in the ear canal or outer ear, along with temple and/or forehead pain, fever, fatigue, and a loss of appetite. Vision changes and pain with chewing may also be present.

Mastoiditis

If a middle ear infection remains untreated, the infection may spread to the mastoid bone—a spongy, air-filled bone that is part of your skull. A mastoid bone infection (mastoiditis) causes pain, redness, and swelling behind the ear.

If mastoiditis is not recognized and treated promptly, it can lead to complications like a brain or skull bone abscess, meningitis, facial nerve paralysis, or hearing loss.

When to See a Doctor

If you are experiencing ear pain that is worsening, severe, or persisting for two or more days, be sure seek medical attention.

Other examples of situations that warrant a doctor’s attention include:

• Ear pain accompanied by a fever and/or a sore throat
• Pain when tugging on your earlobe
• Ear discharge
• Ringing in the ears, dizziness, or hearing loss
• Swelling or rash of the ear canal or earlobe

Diagnosis

Diagnosing ear pain often only requires a medical history and physical examination by a primary care physician or an ear, nose, and throat (ENT) specialist. Imaging and blood tests are less commonly needed.

Medical History

When you see your doctor for ear pain, you can expect him to ask several questions related to the details of your pain:

• What does the pain feel like?
• Does the pain come and go or is it constant?
• Are there any associated symptoms present, such as fever, hearing loss, balance problems or dizziness, ear drainage, or tinnitus (ringing in the ears)?
• Have you recently been ill or experienced any trauma to the face or ear?

Physical Examination

During your physical exam, your doctor will inspect the outer ear, ear canal, and tympanic membrane (eardrum) with an otoscope. Your doctor will also inspect your nose, mouth, and sinuses. He may also press on your TMJ, look at your back molars to check for signs of grinding or frequent clenching of the teeth, and examine your neck to look for enlarged lymph nodes or other masses.

Keep in mind, as part of your exam, your ENT may perform a nonsurgical procedure called nasal endoscopy to better examine your nose and sinuses. The endoscope—a thin tube with a camera and light—allows your doctor to better examine your nose, sinuses, and the top of your throat (where the opening of your eustachian tube lies).

Lastly, if you are experiencing hearing loss and/or dizziness (balance problems), your ENT may refer you for a hearing and/or a vestibular function test.

Imaging

Imaging is sometimes needed to sort out an ear pain diagnosis. For example, an X-ray may be ordered to evaluate a dental problem or to examine the jaw in TMJ disorder.

A computed tomography (CT) scan may be necessary if mastoiditis is suspected, especially if a person is experiencing worrisome complications of mastoiditis, like cranial nerve deficits or signs of meningitis.

A CT scan or magnetic resonance imaging (MRI) may also be ordered if your doctor suspects a possible tumor, such as nasopharyngeal cancer or cholesteatoma, as the source of your ear pain. An MRI to examine your brain may be used to evaluate for a diagnosis of Meniere’s disease, as central nervous system conditions, like a brain tumor or multiple sclerosis, may mimic the symptoms of Meniere’s disease.

Blood Tests

Blood tests may be used to help diagnose various ear pain conditions. For instance, if your doctor suspects a severe infection, especially mastoiditis, he may order a white blood cell count and inflammatory marker tests, namely erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Blood tests may also be used to rule out concerns like thyroid disease, diabetes, and syphilis, all of which may have symptoms similar to those of Meniere’s.

Treatment

As there are many different causes of ear pain, there are similarly many possible treatments. The treatment of choice will specifically depend on the root cause of your ear pain.

Self-Care Strategies

Simple, at-home therapies can sometimes go a long way in easing your ear pain, especially if your ear pain is related to fluid build-up from a virus or allergies.

For instance, in order to ease the congestion of sinusitis, otitis media, or eustachian tube blockage, your doctor may recommend taking an over-the-counter decongestant or using a nasal spray.

Other self-care strategies that may be helpful include:

• Hold a warm compress against your ear or sinuses
• Apply mineral oil or diluted hydrogen peroxide followed by a warm shower to loosen congestion
• Yawn or chew gum in order to try “pop” your ears
• Drink lots of water (six to eight glasses per day)

Self-care strategies also play an important role in managing TMJ syndrome. These strategies include:

• Performing simple jaw exercises
• Avoiding triggers of TMJ pain (e.g., chewing gum or grinding your teeth)
• Using a bite guard when you sleep
• Engaging in relaxation and stress management techniques

Ear Flushing

Ear flushing is performed by a healthcare professional to remove impacted wax. The procedure is also used to remove debris, infected material, and dead skin cells in the treatment of otitis externa.

Medications

Several different medications may be used to treat your ear pain:

Ear Drops

Earwax-softening drops may be recommended by your doctor if you have earwax buildup.

Likewise, ear drops are the primary treatment for external otitis. There are many different types of ear drops available, including antibiotics, acidifying solutions, and steroids. Many of these ear drops work in combination to reduce inflammation, treat the infection, and ease pain.

Oral or Intravenous Antibiotics

Sometimes oral (by mouth) or intravenous (by vein) antibiotics are required to treat more serious causes of ear pain, such as:

• Bacterial sinusitis
• Severe cases of external otitis, including necrotizing (malignant) external otitis
• Perichondritis
• Mastoiditis
• Periauricular cellulitis

Pain Relievers

To soothe your ear pain, your doctor may recommend over-the-counter Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen). For the pain of TMJ syndrome, your doctor may also prescribe a muscle relaxant or a tricyclic antidepressant.

Surgery

A surgical procedure called a myringotomy is sometimes needed to treat chronic middle ear infections or persistent eustachian tube dysfunction.

With a myringotomy, a small hole is made in your eardrum to ease pressure and let the fluid drain. An ear tube may then be placed in the eardrum to allow airflow into the middle ear and to prevent fluid from re-accumulating.

Surgery may also be indicated for other ear pain diagnoses like a tumor, severe mastoiditis, or abscess formation in perichondritis.

Prevention

Here are a few strategies that may help prevent certain ear pain diagnoses:

To prevent earwax buildup:

• Avoid chronic use of cotton swabs or earwax softening agents, such as Debrox (carbamide peroxide)
• If you suffer from frequent episodes of earwax buildup, consider regular use of topical emollients or a routine ear cleaning by a healthcare professional every six to 12 months

To prevent external otitis (“swimmer’s ear”):

• After swimming, blow-dry your ears (using a low setting and holding the hairdryer about a foot away).
• Consider wearing special earplugs for swimming.
• Avoid sticking your finger or towel into your ears after swimming.

A Word From Verywell

Ear pain is not only unpleasant, but it’s oftentimes distracting and frustrating. The good news is that the majority of diagnoses are curable, especially if treated promptly. With that, be sure to see your doctor if you develop ear pain, so you can get back to enjoying life.

Otalgia and Otorrhea – Clinical Methods

Otalgia

Referred pain is an incompletely understood phenomenon wherein nerve impulses emanating from a distant or deeper structure are localized to a more superficial structure of the body. The site of pain referral generally follows the dermatomal rule. Well-known examples of this phenomenon are shoulder pain caused by diaphragmatic pleurisy and pain down the inner side of the arm and little finger of cardiac origin. In each situation, the pain spreads from one area to another through nerve branches that have a common central origin within the same segments of the gray matter of the spinal cord.

Referred pain generally comes from viscera and muscles and is often described as deep pain. The faulty projection of deep pain to the surface is thought to be the result of infrequency of deep pain and inability to use vision to verity the source of stimulation; thus, learning appears to be an important factor in referred pain.

Evidence that reference of sensation is a learned phenomenon can be found in the clinical observation that a pain may be referred not to its usual point of reference but to a site of previous surgical operation, trauma, or localized pathologic process. Some individuals suffer severe pain localized to the teeth during high-altitude flying. Upon exclusion of every possible dental cause for pain, it was discovered that the pain stimulus was expansion of air trapped in the maxillary sinus. The group referring pain to the teeth had a high incidence of traumatic denial work on the side of reference, suggesting habit reference of pain. Under experimental conditions, it can be shown that a projection of pain is learned and that pain impulses conducted in overlapping pathways are simply given the previously learned reference for impulses in that path. Neither habit reference nor any other theory of referred pain can fully explain the phenomena that occur.

When pain is referred to the ear from a painful lesion elsewhere, it is likely that both the ear and the area containing the lesion receive sensory innervations from the same cranial nerve and that spread occurs by way of central connections within the gray matter of the brainstem.

The nerve supply to the external auditory canal and the middle ear comes from three cranial nerves; the trigeminal, glossopharyngeal, and vagus, and from the cervical plexus via the lesser occipital nerve (c2) and the great auricular nerve (c2–3). A small portion of the auricle, the superior and anterior walls of the external canal, and the anterior part of the tympanic membrane are supplied by the third branch of the auriculotemporal branch of the third division of the trigeminal nerve. Practically the whole surface of the auricle receives its sensory innervations from the great auricular and lesser occipital nerves. The inferior and posterior walls of the external canal and the posterior portion of the tympanic membrane are supplied with sensory fibers from the auricular branch of the vagus nerve. It is generally correct to state that the ganglionic representation of the sensation of the auricle and external canal can be divided into the gasserian ganglion in front, the second and third cervical ganglia behind, and jugular ganglion in between.

The tympanic plexus that lies on the promontory is formed mainly by nerves derived from the tympanic branch of the glossopharyngeal nerve but also receives branches from the geniculate ganglion of the facial nerve. Sympathetic branches from the carotid plexus join the tympanic plexus, although sensory function is doubtful. The skin overlying the mastoid is innervated by the mastoid branches of the great auricular and lesser occipital nerves, while cells in the mastoid receive their sensory supply through a mastoid branch of the tympanic plexus. Sensory branches from the trigeminal to structures within the middle ear are very questionable.

Referred pain pathways responsible for most cases of otalgia involve the same three cranial nerves that innervate the external auditory canal and middle ear. Painful impulses originating in the region of a diseased lower molar tooth or temporomandibular joint would be traced by way of the gasserian ganglion to the spinal nucleus of the trigeminal (fifth cranial) nerve in the brainstem. This nucleus also connects with ear structures by way of other sensory branches of the third division that innervate the wall of the external canal and tympanum.

Irritative impulses from the tongue or tonsil travel through the glossopharyngeal (ninth cranial) nerve and its ganglia to enter the somatic sensory nucleus of that nerve within the medulla. This nucleus also receives the sensory branches of the ninth cranial nerve from the middle ear and adjacent structures. It is clear again, as in referred pain by the fifth nerve, that the pathway must pass through the sensory nucleus in the medulla.

In the same manner, the somatic afferent pathways of the vagus (tenth cranial) nerve from the larynx ascend through the peripheral ganglia to the spinal nucleus in the medulla and here connect with afferents from the concha and deeper structures of the ear.

The fifth, ninth, and tenth cranial nerves are closely related in their central connection in the brainstem; however, there must be a fair degree of separation within each of the three nerve systems centrally. Otherwise, the localized reference of pain observed clinically would not occur. Beyond a certain level of sensory irritation, there seems to be an overflow into the adjacent centers with more diffuse and poorly localized pain.

The onset, intensity, and duration of ear pain depend on the particular etiology. The cause of all persistent pain must he pursued intensely.

Why noise can cause physical agony

A jovial laugh, to Tom Maholchic, feels like a knife stabbing his eardrums. So do all sorts of routine sounds — the sizzle of bacon, the ring of a phone, the rush of running water.

“I feel like I have a year-round sunburn deep inside my ears,” said Maholchic, 27.

Researchers have known for years about a condition called hyperacusis, where ordinary sounds seem uncomfortably loud. But they’re just starting to understand that some patients experience a more severe form, where noise is not just heard — but is actually felt, as physical pain.

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Using new lab tools and techniques, pioneering scientists have identified what appear to be pain fibers in the inner ear, or cochlea. They are coining new terms, including “noxacusis” and “auditory nociception,” for this newly recognized sensation of noise-induced ear pain.

The new diagnosis will be an important topic next week at the annual meeting of the Association for Research in Otolaryngology in San Diego, where a three-hour symposium will introduce the research and explain its implications. While some patients with the condition do improve, others risk a setback every time they hear even a moderate noise.

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“People’s lives have been radically altered by the crippling pain that comes with this type of rare noise injury,” said Bryan Pollard, president of Hyperacusis Research, a nonprofit.

“The pain lingers long after the sound is gone, much as the pain from a flesh wound would.”

M. Charles Liberman, Harvard Medical School

Patients’ descriptions of the pain are remarkably similar: A sound is usually perceived as the sharp jab of a knife or skewer. The sensation persists as a searing, burning ear pain, often combined with the pressure known as aural fullness and the ringing known as tinnitus.

Maholchic often spends time in this room, so he can look outside the window and feel the sun, since he cannot tolerate going outside during the day. He says that he spends most of his time reading and painting. Kayana Szymczak for STAT

“What even most auditory scientists don’t understand about hyperacusis with pain is that the pain lingers long after the sound is gone, much as the pain from a flesh wound would,” said M. Charles Liberman, a professor of otology at Harvard Medical School and director of a hearing research lab at the Massachusetts Eye & Ear Infirmary.

The problems start with the pea-sized cochlea, a tiny sensory organ buried within a skull bone. It’s tough to reach and impossible to biopsy, thereby hampering experimental work. Within the cochlea, one kind of nerve fiber has long puzzled scientists. These mystery fibers resemble pain fibers elsewhere in the body.

It took 15 years, but using several strains of deaf mice, Jaime García-Añoveros, an associate professor of anesthesiology at Northwestern University Feinberg School of Medicine, found that intense noise causes activity in these fibers. That research, coauthored by Liberman, was published last March in Current Biology.

At around the same time, a lab at Johns Hopkins University found that when certain sensory cells of the cochlea are damaged, as might occur during very loud noise, they release a chemical that activates the mysterious pain fibers. In some people, these fibers seem to switch on — and never switch off.

Noise loud enough to cause immediate pain — like a gunshot or a firecracker going off at close range — is so rare that few people ever experience it, except those in the military.

But exposure over time to more modest noise — from music, movies, sirens, lawnmowers, and a thousand other everyday things — can damage hearing and set off the pain fibers.

Indeed, noise can cause damage even if it doesn’t feel uncomfortably loud in the moment. “Young people don’t report a rock concert as a painful experience,” said Paul Fuchs, a professor of otolaryngology at the Johns Hopkins University School of Medicine, whose research was published in the journal PNAS in November.

Individual susceptibility to noise exposure varies greatly, and may be genetic. There’s no firm estimate of how many people may suffer from noise injury.

Maholchic’s collection of noise reduction earmuffs. Kayana Szymczak for STAT

Few doctors or audiologists are even aware of the condition, though the new findings may encourage them to take patients who complain of ear pain more seriously. “It is time for pain hyperacusis to be recognized as a real symptom, not as a psychosomatic phenomenon,” García-Añoveros said. “This is, in a way, a new sensory modality — a hybrid of pain and hearing.”

For Maholchic, the pain came on abruptly and quite unexpectedly. He never thought his noise exposure was at all unusual. At his student job at the University of Massachusetts, he listened to music on his iPod while he vacuumed. He played in a garage band. Later, he worked at a loud, lively restaurant.

His only symptoms were ear fatigue after band practice and bursts of discomfort from clanking dishes at the restaurant. These warning signs, seemingly inconsequential, quickly resolved.

One night two years ago, however, his ears started ringing. Within weeks, “barking dogs, crowded places, and pretty much any noise considered remotely loud sent shockwaves through my head,” he said in an interview conducted by email, since he must limit his time on the phone.

Maholchic had been living in California, but moved back in with his parents in suburban Boston because the pain was so debilitating. To cushion him from noise, the house has soundproof windows and plenty of carpeting. Maholchic also sometimes wears earplugs or protective earmuffs. And he rations his time spent in potentially painful settings. “If I manage my noise exposure well, I can handle noise better,” he said.

Maholchic has improved enough to be able to take occasional late-night walks while his neighborhood sleeps. But just one surprise noise, like a honking horn, erodes his progress.

“The louder the noise, the greater the impact,” he said. “It angers me to think about all the unnecessary noise I exposed myself to. I was unaware of the harm it could cause.”

Ear Barotrauma | Cedars-Sinai

Not what you’re looking for?

What is ear barotrauma?

Ear barotrauma is a type of ear
damage. It is caused by pressure differences between the inside of the ear and the
outside of the ear. It can cause pain and sometimes lifelong (permanent) hearing
loss.

The middle ear is an air-filled
space between the inner and outer parts of the ear. It contains 3 small bones that
help
transmit sound. It also contains the opening of the eustachian tube, which connects
to
an area behind the nose. This tube stays closed most of the time.

For your hearing to work normally, the pressure inside the middle ear has to match
the air pressure in your environment. If the external pressure is greater or less
than the middle ear pressure, the eustachian tube should open. This equalizes the
pressure between the middle ear and the outside.

Sometimes the eustachian tube can’t
open normally when there are changes in pressure. When that happens, the difference
in
pressure can damage the eardrum. The eardrum separates the outer and middle ear. This
might cause bleeding or other damage to the outer, middle, or inner ear.

People of all ages can have ear
barotrauma. It is common in scuba divers. Air travel is also a common cause of ear
barotrauma.

What causes ear barotrauma?

Ear barotrauma results from a
pressure imbalance between the inside of the ear and the outer environment. This
pressure imbalance only happens in certain circumstances, such as:

• Scuba diving
• Air travel
• Hyperbaric oxygen therapy for wound healing
• Exposure to an explosive blast

But most people in these situations
don’t develop ear barotrauma. This condition happens when there is also a problem
with
the eustachian tube. Anything that causes inflammation or fluid buildup in the area
around the tube may cause it to not open normally. These may include factors such
as:

• Allergies
• Sinus congestion
• Having a cold or other infection
• Anatomical abnormalities
• Exposure to irritants such as tobacco
  smoke
• Certain hormonal changes (for
  instance, during pregnancy)

Who is at risk for ear barotrauma?

Any activity that causes large
changes in the external pressure carries a risk of ear barotrauma. For instance,
military staff are more at risk from ear barotrauma due to explosions. You will have
an
increased risk if you have any of the above factors that can cause problems with the
eustachian tube. Not using the correct scuba diving technique can also raise your
risk
for ear barotrauma.

What are the symptoms of ear barotrauma?

The most common symptoms of ear barotrauma may include:

• Feeling of pressure in the ear
• Ear pain
• Dizziness
• Feeling like you have a blocked ear
• Bleeding from the ears or into the middle ear
• Ringing in your ears
• Hearing loss

You might have only mild symptoms,
or your symptoms might be more severe. A feeling of pressure in the ear is often a
first
symptom. Ear pain and hearing loss may occur over time if the pressure difference
badly
damaged your ear.

Some situations that cause ear
barotrauma may also damage the lungs and sinuses. These might cause additional symptoms,
such as pain of the face or shortness of breath.

The symptoms of ear barotrauma may
seem like other health conditions or problems. Always see your healthcare provider
for
more information.

How is ear barotrauma diagnosed?

Your healthcare provider can
diagnose ear barotrauma with a health history and physical exam. This may include
an
exam of the ear, as well as hearing and balance tests. Your provider can only make
this
diagnosis if you recently had changes in external pressure, such as from a recent
scuba
dive or an airplane flight. Your primary healthcare provider might first diagnose
you
and then refer you to an ear, nose, and throat doctor (ENT or otolaryngologist) for
treatment.

How is ear barotrauma treated?

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

You may not need any treatment if
you get ear barotrauma. Most injuries heal on their own with time, and most people’s
symptoms will go away. But your eardrum might not heal normally if a blast caused
the
injury.

You might need medicines for your
ear barotrauma. These might include:

• Nasal steroids and decongestants, to
  reduce congestion around the eustachian tube opening
• Antibiotics, if an infection
  develops
• Pain medicine

You might need surgery if your ear
barotrauma is severe. Your healthcare provider might reconstruct the eardrum or the
opening into the inner ear. Sometimes a tiny cut (incision) is made in the eardrum.
In
rare cases, placing a ventilation tube in the eardrum may be advised

Your healthcare provider may also
advise complete bed rest and keeping your head raised for some time.

What are possible complications of ear barotrauma?

Often the symptoms following ear
barotrauma go away with time. But it sometimes causes symptoms that don’t go away,
such
as:

• Dizziness
• Ringing in the ears
• Hearing loss (which may require a
  hearing aid)

Following your healthcare
provider’s advice about possible surgery or bed rest may help reduce your risk of
these
complications.

What can I do to prevent ear barotrauma?

You can do things to help prevent
ear barotrauma. If you are congested from a cold or allergies, you may want to delay
flying or scuba diving. Or you can take medicine such as a decongestant or
antihistamine. These may help your ears equalize more easily and prevent ear
barotrauma.

You can use certain methods to open
the eustachian tube during pressure changes, such as:

• Swallowing frequently
• Pinching your nose, closing your mouth, and then acting as if you were going to breathe
  out through your nose
• Chewing gum or candy
• Using special ear plugs when flying

Ventilation tubes are another
option for some people whose eustachian tubes don’t work well or for those who need
to
fly frequently. They may also benefit you if you need hyperbaric oxygen therapy for
wound healing. A surgeon places these tubes in the eardrum, and they prevent future
pressure differences. (Ventilation tubes can’t prevent ear barotrauma caused by
diving.)

Living with ear barotrauma

If you are a diver, don’t dive
again until your injury has fully healed. Diving again too soon can cause reinjury.
Your
healthcare provider will tell you when it’s safe for you to dive again. You should
also
not fly until your provider says it’s OK.

Key points about ear barotrauma

• Ear barotrauma is a type of ear damage caused by pressure
  differences between the middle ear and the outer ear.
• Scuba diving and air travel are
  common causes of ear barotrauma.
• This condition occurs when there is
  also a problem with your eustachian tubes.
• Symptoms can include ear pain,
  ringing in the ears, dizziness, ear bleeding, and hearing loss.
• Symptoms are often short-term
  (temporary). But some don’t go away.
• Treatment may include medicines or
  surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
  or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also
  know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Ashutosh Kacker MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: Daphne Pierce-Smith RN MSN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Ear Pain Isn’t Always About Your Ear: 3 Other Causes

In many cases, ear pain is caused by an infection of the ear canal. But did you know some ear pain may not be connected to ear-related problems at all? Many of these problems require a physician’s knowledge to distinguish one problem from another. But here are a few other causes of ear pain you may not know about.

1. Otitis Media

Otitis media is a group of diseases, most prevalent in the younger age groups, and is an infection of the eardrum. It often happens because of inadequate development in the Eustachian tube.

Adults may develop otitis media if they have bad allergies which lead to an ear infection. In some cases, a head cold could lead to dysfunction in the Eustachian tube, which could then lead to an ear infection.

Read More: 9 Myths About Ear Infections in Children

2. Acute Otitis Externa (“Swimmer’s Ear”)

Swimmer’s ear is a common ear ailment — so common that it’s not even limited to frequent swimmers. Swimmer’s ear can happen to anyone who happens to get extra moisture in the ear. It can come from something as common as an extra shower a day.

Despite what you may think, swimmer’s ear does not involve the eardrum. It’s an infection of the skin of the ear canal itself. However, it takes a physician to diagnose the difference between swimmer’s ear and an ear canal infection, and both ailments are treated differently. If you are experiencing pain and redness in the outer ear and think you might have swimmer’s ear, you should probably see a physician.

3. Temporomandibular Joint Dysfunction (TMJ)

TMJ has nothing to do with the ear but often results in ear pain. Why? When the jaw joint is directly in front of the ear experiences stress, it can irritate the joint. This irritation can come from gum chewing, clenching or grinding one’s teeth, or personal stress. This irritation manifests as pain in the ear, even though it has nothing to do with the ear at all.

Physicians often see a spike in TMJ during the holidays and winter season, due to the increased stress. As with swimmer’s ear, it often takes a physician’s expertise to distinguish the ailment from others like it.

When to See a Physician

Why should you see an ENT when you’re experiencing ear pain? Because ENTs like to rule out the possibility of more serious conditions.

For example, throat cancer on one side of the throat can create referred pain in the ear. Because cases of HPV have increased nationwide, you can develop throat cancer even if you’re not a smoker. So if you’re experiencing ear pain, it’s best to consult an ENT even if you don’t smoke.

Other conditions that can cause ear pain include inflammation or infection of salivary glands, which are close to the ears. Allergies can cause ear pain or pressure that does not normally stabilize.

In most cases, ear pain is likely to be a simple infection or one of the conditions listed above. When you schedule a visit with an ENT, we perform an exam of the ear canal, eardrum, throat, back of the nose, and neck, to rule out these possibilities, and any other possibilities of an unusual source.

If you have questions about possible sources of ear pain or want to get your ear pain checked out, contact Virginia ENT today to schedule an appointment.

90,000 Causes of ear pain

Pain in the ear can have a different character: acute pain, discomfort, squeezing. It is important to understand that painful sensations are not always accompanied by somatic pathology. For example, after a walk in windy weather, you can experience discomfort in the depths of the auricle, comparable to pain. This is completely normal and does not require any treatment: after a while, the discomfort occurs naturally. The painful sensations are also familiar to fans of water swimming.When water is frequently drawn into the ear canal, it causes softening of the skin and therefore slight swelling. In this case, a person may experience a feeling of squeezing, a dull pain. Finally, one of the most common causes of ear discomfort is excessive or insufficient sulfur production. In the event that there is too much sulfur, it forms the so-called sulfur plug, which causes hearing impairment – hearing loss – and causes discomfort. If the sulfur produced by the body is not enough, the skin in the ear canal will be dry, which will also cause pain.

Among the most common causes of pain syndrome are:

Otitis media;

Injury

Sinusitis;

· Pain in the ears due to caries;

· Neuralgia of various etiologies;

· Inflammation of the jaw joints;

Eczema of the ear canal;

· Penetration of small insects into the ears;

Angina.

· Obviously, the list of causes includes quite versatile diseases, therefore, for a correct diagnosis, it is important not to dwell solely on the pain syndrome, but to consider the entire symptomatic picture as a whole.

Symptoms associated with ear pain

When a patient comes to the doctor with certain complaints, it is very important to conduct a correct differential analysis in order to accurately determine the disease that manifests itself with ear pain. It is extremely important to cover the entire clinical picture as a whole.

o Inflammatory processes in the ear canal . Usually accompanied by general intoxication of the body, due to which the patient feels weak, drowsy, and decreased performance.The temperature may rise. With otitis externa and otitis media, the pain intensifies if you press or pull on the ear with the palm of your hand. With otitis media (inflammation of the ear canal behind the eardrum), the pain becomes intense during the chewing process. If otitis media develops without proper treatment, hearing loss may occur. Internal otitis media, or as it is called otherwise, the labyrinth, in addition to pain, gives a number of, at first glance, neurological symptoms: a feeling of instability when walking, dizziness with nausea and vomiting, nystagmus of the eyeballs.

o Ear injuries . An external examination can reveal bruises, bruising. A very serious symptom is bleeding from the ear canal, mixed with a clear liquid – this may indicate a fracture of the skull bone. In case of burns or frostbite, the skin of the auricle has an appropriate appearance, which greatly facilitates the diagnostic process. A ruptured eardrum is usually accompanied by fainting, tinnitus. Severe pain decreases with increasing hearing loss.

o Foreign objects in the ear canal . Most often, this cause of pain occurs in children, who can shove a small object into the ear. Sometimes insects get into the ear canal. The difficulty in extracting is that the ingress of a foreign object is always accompanied by swelling, so the object or insect remains “walled up”, out of reach. At the same time, unbearable itching is noted, which prompts you to independently reach the interfering object with a cotton swab or knitting needle.It is categorically impossible to do this, you need to seek medical help.

o Pain due to jaw disease . If the pain in the ear is intermittent and is noted in other parts, for example, in the teeth when clenching the jaws or other bones of the face when pressed, then one can suspect that the pain from the problem area “gives” to the ears. This situation often occurs with angina, when swallowing is accompanied by mild ear pain, removal of tonsils, wisdom teeth, or cutting off the gum hood from the distant teeth.Ear pain is often the result of tooth decay or suppuration in the gums.

Methods for diagnosing ear pain

In most cases, it is enough for the doctor to conduct an external examination using a special device that allows you to expand the ear canal and examine the condition of the eardrum and ear tissues in order to understand what is causing the pain.

o

o We recommend that you check your hearing once a year at our Spektr Hearing Rehabilitation Center located in the city of Smolensk, 10 V. Lomonosov Street.And also you can write to us in our VKontakte group https://vk.com/spectrsurdolog. Our center employs highly qualified workers who will be happy to help you and solve your problem.

Ear pain in a child | Medical center “Serdolik”

Ear pain in a child can occur for a number of reasons.

The main ones:

1. Pain of a cold nature.
   Perhaps the child was in a draft, or was outside without a hat in windy weather.
2. Foreign object has entered the ear.
   This can be an insect crawling into the ear, dust or wool particles, a piece of cotton wool, hair particles that got into the ear when cutting, etc.
3. Injury to the auditory canal.
   This happens most often with careless ear cleaning. A cotton swab or match wrapped with a piece of cotton wool can scratch the skin of the ear canal.
4. Large amount of water has entered the ear.
   This can happen while swimming or swimming in the pool.Water entering the ear can thin the earwax layer (which lines the ear canal, protecting it from infections), and lead to otitis externa (or, as it is also called, “swimmer’s ear”). In this case, the skin, unprotected with a layer of sulfur, becomes very susceptible to infections. One of the main signs of otitis externa is the appearance of a rash on the skin of the external auditory canal.
5. Non-compliance with hygiene rules.
   The development of the sensitivity of the auditory canal can also provoke neglect of hygienic cleaning of the ears.In this case, excessive amounts of earwax accumulated in the ear canal dries out. Particles of dry sulfur cause peeling of the skin lining the ear canal.
6. Consequences of a blow to the ear.
   A child can be injured by falling, playing or fighting. In this case, the ear will hurt.
7. Differences in atmospheric pressure (for example, during takeoff and landing, during air travel), diving to a depth (diving, diving).
8. Radiating pain.
   In this case, the pain radiates to the ear due to pain in the jaw, teeth, tongue, or with inflammation of the glands)
9. Middle ear infection (otitis media).

Otitis media can be a consequence of colds of the upper respiratory tract, inflammation of the tonsils, allergic reactions. Otitis media occurs due to edema of the Eustachian tube. In this case, the pain intensifies when blowing your nose, swallowing and chewing

In children under 1-2 years of age, edema may also occur if the child drinks from a bottle while lying on his back.

Swelling and blockage of the Eustachian tube leads to increased pressure in the middle ear and accumulation of fluid.This inflammation can affect the eardrum and even rupture. The main symptoms of otitis media are: severe pain, a noise or ringing sensation in the ear, a feeling of heaviness in the ear.

Possible symptoms: fever, pain with weak pressure on the ear, increased irritability, or, conversely, apathy, weakness, nausea, vomiting, diarrhea.
In infants, symptoms may include screaming, restlessness, touching the ear, rubbing the head against a pillow.
When the tympanic membrane is ruptured, a little blood is released from the external auditory canal, and then purulent discharge of a yellowish or greenish color.

Caution! If you experience ear pain, you should immediately consult a doctor! A neglected disease can have the most dire consequences from partial hearing loss to the development of meningitis.

Ways to alleviate the condition before contacting a specialist.

1. To seat the child or, in the case of an infant, raise the baby’s head by placing a thick pillow under it.
2. Offer to chew the gum for a few minutes.
   This method is often used for air travel, but it can work outside of them. Chewing relieves pressure in the middle ear area and can relieve pain.
3. Give the child pain reliever. For this, ibuprofen or paracetomol is suitable. ?Warning. Aspirin is contraindicated in children under 12!
4. Use vasoconstrictor drops. A few drops of a vasoconstrictor placed in the nose will remove excess mucus that is blocking the Eustachian tube and the pressure in the ear will ease.In addition, the action of the drug can contribute to the outflow of pus. In this case, the pus will drain down the tube into the throat.
5. Alcohol compress.

? Caution: the compress should not be done at elevated temperatures! For a compress, you need to dilute alcohol with water in a 1: 1 ratio. It is important that the liquids are not cold. Then you need to prepare the first layer of compress: moisten gauze, or a clean cloth, prepared with liquid, and lay it around the sore ear. You can also make an ear slot in the fabric.For the second layer, cover the first layer of the compress with polyethylene (you can take waxed paper) The third layer consists of cotton wool, which is laid out on the previous 2 layers. The compress must be fixed with a scarf or scarf.

? Caution: if pain and fever persist for two days, a second visit to the doctor is necessary!

We invite you for a consultation with a pediatric otorhinolaryngologist in Novosibirsk. Entrust your health to professionals. We are waiting for you at the reception!

Inflammatory processes of the ear | Centrum Słuchu i Mowy MEDINCUS

Acute otitis media Exudative otitis media Chronic otitis media Branches where otitis media and ear pain can be diagnosed and treated

Otitis media

Otitis media is one of the most common ear diseases in children, most often of bacterial etiology.It manifests itself in acute pain and is the result of the spread of a bacterial infection from the nose or throat. Otitis media should not be underestimated. If left untreated, it can lead to serious complications.

Distinguish between acute, exudative and chronic otitis media.

Acute otitis media

Acute otitis media is an inflammatory process characterized by sudden onset of symptoms: severe, throbbing ear pain, fever, hearing impairment and symptoms observed on physical examination: a reddened, bulging eardrum and the presence of fluid discharge in the tympanic cavity.Mostly children are ill. Sometimes it occurs in adults, but in this group we are more likely to observe chronic otitis media, which can be the result of untreated or poorly treated acute otitis media in childhood.

Predisposing factors for otitis media are Eustachian tube dysfunctions, genetic factors, gastroesophageal reflux disease, environmental factors, immunological disorders, allergic diseases, secondhand smoke, artificial feeding of children, and abnormal anatomy of the facial skull.

When to contact a specialist:

For the diagnosis of acute otitis media, the following criteria must be met simultaneously:

1) Sudden onset of illness characterized by ear pain, restlessness, irritability, or crying; increased body temperature; purulent discharge from the external auditory canal.
2) Significant redness of the eardrum or severe pain in the ear that interferes with the normal functioning of the child or his sleep.In addition to symptoms typical of acute otitis media, such as severe, often throbbing pain in the ear, a feeling of fullness in the ear and hearing impairment, general symptoms may also appear: fever, malaise, lack of appetite, anxiety, vomiting, diarrhea; the smaller the child, the more severe these symptoms. In 50% of cases, acute otitis media occurs without ear pain. Soreness when pressing on the ear tragus is not a characteristic symptom of otitis media and can only indicate otitis externa.

Acute otitis media can be severe or mild. A severe course of the disease is characterized by an increase in body temperature> 39 ° C and severe pain in the ear, a mild course – a temperature of less than 39 ° C and moderate ear pain.

Recurrent acute otitis media can also be distinguished, in which episodes of acute otitis media occur at least 3 times in the last 6 months or at least 4 times in the last 12 months.

Treatment

In the treatment of acute otitis media in children, drugs are used that relieve symptoms of the disease, analgesics and antipyretics that reduce the inflammation in the Eustachian tube, and in some cases antibiotics are indicated.Ear pain, especially on the first day of illness, must be treated regardless of the decision to use an antibiotic.

The main goals of treatment for acute otitis media include eliminating symptoms as soon as possible, eliminating bacteria from the middle ear cavity, and preventing suppurative complications of infection. Immediate antibiotic treatment is usually recommended for acute otitis media, but the final decision is made by the doctor.

It should be remembered that inappropriate treatment of acute otitis media can lead to complications such as acute mastoiditis, paresis or paralysis of the facial nerve, otitis media and intracranial complications.

Exudative otitis media
With exudative otitis media, there are no signs of acute otitis media or chronic otitis media. Exudative otitis media can last for many months or years. This is an inflammatory disease of the mucous membrane of the Eustachian tube, tympanic membrane and air cells of the mastoid process (the presence of yellow or amber discharge behind the intact tympanic membrane, which thickens over time). The main symptoms are hearing impairment and tinnitus.During the course of the disease, fluid collects in the tympanic cavity without perforating the tympanic membrane. Long-term presence of such a discharge in the ear leads to a gradual deterioration in hearing.

Causes of exudative otitis media
One of the most common causes of this disease in children is hypertrophy of the pharyngeal tonsil, which presses on the mouth of the Eustachian tubes in the nasopharynx, thereby causing obstruction and dysfunction. Other causes in children are allergies and anatomical features of the nose.Very often this disease occurs in children with a cleft palate and genetic syndromes, which are accompanied by an abnormal anatomical structure of the head and neck. Otitis media is usually asymptomatic in the first stage, is not noticed by children or parents, and – what should be emphasized – should not be treated with antibiotics (with a few exceptions).

Initially, the exudate in the middle ear is watery, over time, due to the presence of the so-called goblet cells that produce mucus, it turns into a viscous discharge.This discharge builds up in the tympanic cavity, causing a full ear sensation and impairment of hearing. If exudative inflammation is present for a long time, at least several months, then the exudate turns into a dense discharge that blocks the space of the middle ear. Such a discharge is much more difficult to remove, even by surgery. This can lead to obstructive otitis media and, which follows, to permanent deterioration of the conductive system of the middle ear (ossicles), which leads to hearing loss.

Among other causes of exudative otitis media in children, thyroid diseases with hypothyroidism, Turner syndrome and barotrauma (for example, after a flight in an airplane) are distinguished. An extremely rare cause in children is nasopharyngeal tumors, while in adults, especially with unilateral otitis exudative, always suspect a tumor that can block the mouth of the Eustachian tube and cause dysfunction.

When should I see a doctor?

Symptoms of chronic exudative otitis media:

• Exudative otitis media can be asymptomatic and undiagnosed for a long time, especially in young children.This is due to the fact that usually the exudate in the middle ear appears gradually, and the child gets used to its presence, without informing the parents about the hearing impairment.
• If symptoms are present, the child may complain of hearing impairment or a feeling of fullness in the ear, water in the ear – like after a pool. Less commonly, children complain of ear pains that are not intense in the case of exudative inflammation.
• Ear pain with exudative inflammation can be caused by a retracted or bulging eardrum when fluid fills the entire space in the middle ear.
• Changing the child’s behavior should also attract the attention of the parents. Irritability, lack of response to a call, hyperactivity can be manifestations of hearing impairment, especially in a situation where the child previously behaved properly.
• Discharge from the ear is not characteristic of exudative otitis media. If they appear, this may indicate the appearance of another disease: the formation of perforation of the tympanic membrane, chronic otitis media, inflammation of the external auditory canal.These conditions are associated with more serious and severe ear conditions and in many cases must be treated with surgery.
• An increase in body temperature is also not a symptom of exudative otitis media. In the event of fever and severe ear pain, acute otitis media may be suspected, which should be treated with an antibiotic. The decision to use the antibiotic rests with the doctor.
  How is exudative otitis media diagnosed?
  one.A medical examination in an otolaryngological office should be aimed at identifying the cause of exudative otitis media and determining the child’s hearing loss.
  2. The doctor examines the ear with a video otoscope.
  3. Otoscopic examination is a basic examination, thanks to which the doctor can assess the condition of the middle ear and the extent of damage to the tympanic membrane or elements of the middle ear. The doctor also evaluates the patency of the nose and throat, since exudative otitis media in children is very often associated with the presence of hypertrophy of the tonsils and especially the pharyngeal tonsil, which is located high in the nasopharynx.
  4. To assess the presence of adenoids and their size, a fibroscopic examination of the nasopharynx should be performed using a thin camera inserted through the child’s nose.
  5. After the examination of the child, additional audiometric tests are performed. The basic test for children is impedance measurement. This examination allows you to accurately assess the condition of the middle ear, and also allows you to monitor the progress of the child’s recovery. To assess hearing in children, an examination is carried out for the presence of so-called otoacoustic emissions.It is also a quick and painless examination. In older cooperating children, tonal audiometry may be done to assess the degree of hearing loss.
  6. After examining the child and additional tests, the doctor can determine the most likely cause of the disease and suggest appropriate treatment. Sometimes the child needs additional advice from other specialists, especially an allergist, since the presence of allergies can affect the onset and course of exudative otitis media in a child.Treatment for a child with allergies is also more difficult and time-consuming.

Treatment of exudative otitis media

Treatment of exudative otitis media should be planned with knowledge of the underlying cause. If the exudative inflammation is due to acute otitis media, the procedure may be limited to monitoring the child. In general, the fluid in the middle ear disappears within a few weeks, but it can also persist for several months.As long as there is no hearing impairment or other bothersome symptoms, the child should be monitored with periodic otoscopy and audiometry.

In case of exudate and hearing problems in a child, the doctor may prescribe pharmacological treatment, including topical medications for use on the nasal mucosa, which reduce swelling and inflammation. If allergies are detected, antiallergic drugs are recommended.

Surgical treatment should be considered if symptoms of exudative inflammation persist for more than 3 months despite proper treatment.

If the child still has symptoms of adenoiditis, an adenotomy should be performed, that is, removal of the pharyngeal tonsil. Surgical treatment of adenoids often addresses the underlying cause of exudative otitis media.

For a child with a cleft palate and after reconstructive surgery, the decision on ventilation drainage should be made earlier, because exudate appears at an early age and is characterized by a long course. Cleft palate predisposes to ear inflammation, including otitis media, which is difficult to treat, often requiring re-drainage of the tympanic cavity or permanent ventilation drains.

Chronic otitis media is characterized by the permanent presence of perforation of the tympanic membrane, that is, its rupture, persistent or recurrent discharge from the ear and hearing impairment. In this case, surgery is performed. Chronic otitis media mainly affects adults and is a common consequence of untreated or poorly treated acute otitis media in childhood.

Varieties of chronic otitis media:

• chronic suppurative otitis media
• chronic granulating otitis media
• chronic otitis media with cholesteatoma
• chronic tuberculous otitis media

When to see a doctor:

Symptoms of chronic otitis media:

• The main symptoms of chronic otitis media are hearing impairment from the ear and dizziness after water has entered the ear (in the case of a defect in the tympanic membrane).
• Chronic simple otitis media is characterized by odorless mucopurulent discharge from the ear and hearing impairment.
• Chronic granulomatous otitis media is manifested by profuse mucopurulent discharge from the ear, hearing impairment, recurrent ear polyps and the so-called chronic “wet ear”, the inability to “dry” the ear, despite proper conservative treatment. In the late stage of the disease, bone destruction occurs.
• Patients with chronic otitis media with cholesteatoma also have the following symptoms: bad breath, persistent or intermittent hearing impairment, conductive or mixed hearing loss.
• Acquired secondary cholesteatoma is characterized by profuse, often chronic discharge from the ear with a characteristic odor and rapidly onset hearing impairment.
• Chronic tuberculous otitis media is characterized by the periodic appearance of a small amount of mucopurulent discharge, damage to the inner ear and frequent paralysis of the facial nerve.
• The main manifestations of tympanosclerosis are hearing impairment, often bilateral hearing loss and tinnitus.
• Conductive or mixed hearing loss is characteristic of adhesive otitis media.

Treatment chronic otitis media :

1. Chronic suppurative otitis media is treated pharmacologically. The main task is to combat purulent discharge from the ear, the so-called “ear drying”. After the inflammatory process has subsided, surgical treatment can be performed to improve hearing by closing the defect in the eardrum and reconstructing the ossicular chain.
2. Chronic granulating otitis media requires surgical intervention, since the discharge from the ear cannot be cured pharmacologically in this situation. During the operation, it is necessary to take material for histopathological examination.
3. Chronic otitis media associated with cholesteatoma requires surgical treatment, the main purpose of which is to remove the cholesteatoma and inflamed tissue fragments. If reconstruction of the tympanic membrane and ossicular chain is possible, tympanoplastic surgery is performed.
4. Chronic tuberculous otitis media is treated with anti-tuberculosis drugs. The operation is performed on patients with paresis or paralysis of the facial nerve to clear the granulation tissue from the facial nerve and decompress it.
5. Perforation of the tympanic membrane that does not heal on its own requires surgical repair.
6. Treatment of retraction pockets depends on their degree. The indication for surgical treatment is concomitant hearing loss.Often, early surgical treatment is performed to prevent the development of cholesteatoma.
7. Treatment of tympanosclerosis and adhesive otitis media is carried out by the operating method.

90,000 Ear pain – how to relieve. Treatment of ear diseases in Kiev

The etiology of a symptom such as pain in the ear can be associated with various diseases. She has a medical term of Otology and requires immediate medical attention.Pain syndrome can take on a different nature and requires professional methods of elimination.

Why is ear pain dangerous?

Typically ear pain is symptom of inflammatory disease of the outer or of the middle ear . This has serious consequences.

Development of the inflammatory process

Pain, like other symptoms of diseases, is the body’s response to an irritant.If you do not pay attention to this, chronic diseases of ears appear, which are much more difficult to treat than primary otology .

Complications

Due to pathological processes occurring in diseased ears, complete or partial hearing loss may develop. Sometimes this happens irreversibly. Also, the inflammatory process can switch to adjacent important organs and structures: the facial nerve, temporal bone, meninges.Development of abscesses and other dangerous complications is possible.

Classification

Ear pain can be constant or intermittent. In the first case, a person feels it all the time, in the second, his ears ache with influxes, seizures. It can also be sharp and aching.

Spicy

As a rule, in this case, there is severe pain in the ear . It is accompanied by general symptoms – dizziness, fever, migraines and weakness.Pain syndrome can take on a different nature:

• Pulsating pain in the ear – painful sensations roll over, then recede, and the frequency of these changes is fast, like a pulse.
• Shooting pain in the ear – often occurs intermittently. Inside the ear canal or deep in the ear, as if something were shooting.
• Stitching pain in the ear – usually persistent. The person feels as if a sharp object is injected into the ear.

As a rule, such conditions are dangerous to human health.Therefore, when he has acute ear pain, first aid is needed immediately.

Aching

Usually aching pain in the ear feels less excruciating than acute. It can appear constantly or intermittently. In the ear, as if something is pulling, itching and bursting. Often, such symptoms are observed during the transition of ear diseases from the acute phase to the chronic one. Getting rid of aching pain can be quite difficult – it haunts a person for months before he heals.

Causes of ear pain

When there is ear pain, the causes of are usually associated with inflammation or trauma.

Inflammatory processes

Pathophysiology of this symptom is directly related to a disease such as otitis media . It manifests itself in its various types:

• Diffuse otitis externa – when the skin of the ear canal becomes inflamed.
• Furuncle of the middle ear – in this case the pain is localized and has a pulsating character
• Otitis media – hurts deep in the ear, along with this, other signs appear (congestion, hearing loss)

Ear pain when swallowing is often reflex and associated with inflammatory diseases of other ENT organs: tonsillitis, sinusitis, etc.

Injury

The ear can hurt with mechanical damage, as well as acoustic trauma (from loud sounds) and barotrauma (from pressure drops). Often this symptom manifests itself when the tympanic membrane is perforated.

What to do if my ear hurts?

So, you notice you have ear pain – what to do in this case? It all depends on its nature and frequency. If there is an acute pain in the ear , first aid – consult a doctor.It is impossible to remove it on your own, because the person does not know the reasons. Without this, it is impossible to understand how to relieve ear pain . ENT will also help with aching pain. If it does not appear constantly, but periodically, it is still a reason to see a doctor.

What not to do if you have ear pain?

It is strictly forbidden to warm your ears, and to try to treat with folk methods. Also, pain relievers are not the best answer to the question how to remove pain in the ear .They do not fix the root cause of the problem, it can be dangerous.

Ear pain

Depending on the age of the patient, the pain symptomatology has its own characteristics.

In a child

Ear pain in children manifests itself most often in an acute form. The kids are very sensitive to it – they cry, shout, are capricious. You can recognize ear pain in a child by the way he constantly touches and scratches his ear.

In adults

Adults suffer less from pain syndrome, it is often aching and periodic.However, relieve ear pain in an adult is more difficult – due to chronic processes.

Features of treatment at Betterton

If you are suffering from ear pain, treatment in our ENT center will help to remove it without the risk of relapse. Diagnostics with the help of modern otoscopes allows you to accurately determine the cause, prescribe therapy and make a forecast for the future. Our experienced doctors successfully relieve ear pain for child and adult. You can consult with them at a convenient time for you.

Possible complications of ear pain

If you do not think in time about how to treat ear pain, serious complications can develop:

• Hearing impairment
• Inflammation of the facial nerve and temporal bone
• Meningitis
• Brain abscess

Healthy products for the ears

Ear pain rarely bothers people who eat a healthy diet.Fatty fish, carrots, seaweed, walnuts, spinach, chicken and eggs, and dairy products are good for the ears.

Prevention of ear diseases

Few people like to experience an ear pain . What to do so that it does not appear? Protect your ears from cold and drafts, maintain hygiene, treat inflammation of the ENT organs in time.

Do not try to treat yourself! Consult otolaryngologists at Betterton Hearing Centers in the capital ×

Make an appointment with a doctor:

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90,000 Otitis media in a child: symptoms, first aid

Children often get sick with ARVI.Most infections quickly pass thanks to the protective functions of the baby’s body, proper care, and adequate treatment. However, in some cases, acute respiratory viral infections occur with complications. Otitis media is one of the most common complications of viral respiratory infections in children. This is facilitated by the peculiarities of the anatomical structure in young children, a short, wide and more horizontal auditory tube, which connects the nasopharyngeal cavity and the middle ear, which means that the infection can easily penetrate from the nasopharynx.Otitis media can be caused by infectious diseases such as measles and rubella. Sometimes it happens that the cause of otitis media is the baby’s frequent profuse regurgitation, while food debris can enter the middle ear through the auditory tube and cause inflammation. Adenoiditis often becomes the cause of recurrent otitis media.

How does otitis media manifest

Young children usually start suddenly with a sharp pain in the ear. Older children may complain of hearing loss.Ear pain may be accompanied by a rise in temperature up to 40 ⁰ C. It is more difficult to suspect otitis media in infants, because they cannot complain of pain. Parents may suspect otitis media in a baby on the following grounds:

• Scream, cry.
• Anxiety, moodiness, sleep disturbances, breast refusal.
• Attempts to fiddle with the ear, rolling the head on the pillow.
• Increased screaming and crying when pressing on the ear tragus.

Discharge from the ear is another sign of otitis media.They can be serous or purulent, with an admixture of blood. Discharge from the ears with otitis media occurs as a result of perforation (rupture) of the tympanic membrane. Lack of treatment for this condition can lead to persistent impairment of hearing acuity in the baby, which once again confirms the need for immediate medical attention at the first signs of otitis media.

Otitis media and first aid

Treatment of otitis media should be prescribed by a doctor. You do not need to get involved in treatment without being examined by an otorhinolaryngologist.Usually otitis media is treated with antibiotics, the course of treatment is 7-10 days. Toilet of the external auditory canal, restoration of the patency of the Eustachian tube and regulation of pressure in the tympanic cavity, local and general anti-inflammatory therapy, antibiotic therapy are among the main areas of treatment for otitis media. In some cases, the patient is shown to undergo paracentesis – a therapeutic puncture of the tympanic membrane. Note again that only a doctor can prescribe specific medications for your child.

How can you help at home:

The use of vasoconstrictor nasal drops is an essential component of otitis media therapy. These drugs restore the patency of the auditory tube, which helps to normalize the pressure in the tympanic cavity.

• Place vasoconstrictor drops into the child’s nose. Prefer a drug that you have already used.
• For fever and / or severe pain, give your baby an antipyretic at an age-appropriate dosage.Paracetamol and ibuprofen preparations effectively relieve pain in otitis media.
• The place with otitis media is shown dry heat. It is enough to put on a hat or a scarf covering the ears on the child. Do not use hot compresses or heating pads without a doctor’s prescription. Remember! Any thermal procedures are CONTRAINDICATED in case of suppuration and elevated temperature.
• If purulent or serous fluid comes out of the ear, remove it with cotton wool soaked in 3% hydrogen peroxide solution.

Prevention

It is necessary to promptly treat the nose, nasopharynx and pharynx in children. This is especially true of an increase in the adenoids. If the child breathes heavily through the nose, sleeps with an open mouth, snores, you need to consult an ENT doctor. If your doctor insists on removing the adenoids, consider and agree to this procedure. Treat other viral and bacterial diseases in a timely manner. For infants, the best prevention of otitis media is breastfeeding.

The following guidelines for caring for a child with ARVI will help you reduce the likelihood of developing otitis media:

• Never force a child to blow their nose. When you blow your nose, mucus gets into the Eustachian tubes, which directly contributes to the development of otitis media.
• The patency of the Eustachian tube is usually impaired by the ingress of thick mucus. Therefore, try to keep the child’s mucus liquid with ARVI. To do this, as much of it as possible, and also maintain the optimal temperature in the apartment (not higher than 21 ⁰ C) and humidity (60%).
• use antipyretic drugs in an age-specific dosage when the baby’s body temperature rises above 38.5 ⁰ C. Fever increases fluid loss and contributes to drying out of the mucous membranes. Therefore, its timely relief is also the prevention of otitis media.

Otorhinolaryngologist Irina Valerievna Korzun

“My ear hurts, what should I do?” – Yandex.Qu

Contents:

Otitis media is a complex of symptoms that accompany the inflammatory process in the ear.Depending on the site of localization, clinical manifestations and the presence of exudate, several types of this disease are distinguished. To understand this, you need to start with the anatomy of the ear.

How does the human ear work?

What we used to call the “ear” is nothing more than the outer ear, which is represented by the auricle and the external auditory canal, which rests on the eardrum. This part of the hearing aid, as such, carries a very conditional functional load in comparison with other departments.The task of the auricle is to capture sound waves and direct them into the auditory canal. Even outwardly in form, it remotely resembles a locator.

The middle ear is represented by the tympanic cavity, in which there are three bones – the malleus, incus and stapes. The function of the cavity is to transform and amplify the audio signal. The base of the stapes separates the middle ear from the inner ear. Most of the inflammatory processes we know as otitis media develop right here, in the middle ear.

The inner ear looks like a snail. It is located in the temporal bone and is filled with fluid and hair cells. The functional load of the inner ear is the transformation of sound waves into nerve impulses, which instantly go to the corresponding parts of the brain.

What are the types of otitis media?

Depending on the location, it is customary to distinguish otitis media of the outer, middle and inner ear.

The outer ear is usually very little susceptible to inflammatory diseases.Basically, patients complain of the occurrence of acne and boils, both directly on the sink and in the course itself. In the latter case, the greatest difficulty is the aseptic processing of the boil, especially if it is located deep enough. There is always a danger of damaging the eardrum. If the focus of inflammation grows, then the patient’s hearing may decrease, however, this is due to purely physical factors. After elimination of the rash, hearing returns in full.

The most common is otitis media.This is due to the anatomical features of the cavity. For the transmission of a sound wave, the density of the medium in which it propagates plays an important role. The appropriate pressure is provided by the Eustachian tube, which connects the tympanic cavity to the pharynx. By equalizing the pressure in the cavity with each sip, it also creates conditions for the penetration of infection into the hearing aid from the mouth and nasal passages. This is how otitis media develops.

Inflammation of the inner ear is an extremely dangerous disease that is a complication of otitis media of the middle ear.Inflammation of the labyrinth of the snail develops quickly and is fraught with emergency conditions that pose a threat to the patient’s life – sepsis or meningitis. The likelihood of permanent hearing loss in this case is much higher than with inflammation of other parts.

Depending on the clinical manifestations, otitis media are divided into acute and chronic.

Acute otitis media is characterized by severe pain and rapid onset of symptoms.

Chronic otitis media develops as a result of untreated acute and is an alternation of periods of exacerbation of the disease with periods of remission.

Another classification of otitis media is based on the presence or absence of purulent discharge. Thus, purulent otitis media and catarrhal are distinguished.

How does otitis media develop?

Otitis media is of two types – infectious and traumatic.

Traumatic otitis media is quite rare. The most common type of injury that doctors have to deal with is the consequences of hygiene procedures performed with a cotton swab.It must be remembered that it is necessary to get rid of sulfur only in the area of ​​the external auditory canal. When you try to push the stick deeper, there is a great chance of damaging both the villi located in the thickness and the eardrum itself. If a plug has formed in the ear, which significantly reduces hearing, then this is a reason for a visit to the otolaryngologist.

Another type of injury is related to pressure drop. This is possible when diving to great depths or, on the contrary, when flying.

The lion’s share of all otitis media is otitis media of an infectious nature.They develop as a consequence of acute respiratory infections of a viral or bacterial nature. With significant contamination of the nasal mucosa, a runny nose develops, which is a constant secretion of mucus. This mucus through the Eustachian tube can enter the tympanic cavity and cause inflammation. The thickening and drying of mucus is especially dangerous, as it impedes its natural outflow. An additional factor that contributes to the entry of phlegm into the ear is improper or too intense blowing of the nose.Inflammation in the Eustachian tube – Eustachitis – provokes the formation of pus, which in large quantities can cause perforation (rupture) of the tympanic membrane. After such a spontaneous drainage, the patient’s condition gradually improves, the membrane is scarred, and the pain subsides.

However, a runny nose can cause otitis media, even in the absence of direct infection of the tympanic cavity. The fact is that the abundance of pus in the nasal passages makes it impossible to equalize the pressure through the Eustachian tube.Gradually, the pressure in the cavity becomes negative, which also causes suppuration.

In adults, acute otitis media develops less frequently than in children. This is due to the fact that with age, the diameter of the Eustachian tube increases, which facilitates drainage of the cavity. In addition, adults are less active in sniffing and clearing their sinuses more gently by blowing their nose. With age, adenoids, which are found in every second child, atrophy and stop squeezing the Eustachian tube.

Otitis media symptoms in adults

Symptoms of the disease depend on the localization of the inflammatory process.With otitis media of the external ear, there is moderate hyperemia of the skin, redness of the auricle. Pain may radiate to the temple or jaw, especially when chewing or talking. With the timely sanitation of foci of inflammation – boils and acne – the process quickly stops and the pain disappears.

Otitis media is characterized by the following symptoms:

• Acute inflammation is manifested by severe pain in the ear, which can be either sharp or aching. Most often, patients indicate “shooting in the ear”.

• Symptoms of general malaise are sometimes noted – fever, drowsiness, fever with chills. It should be noted that these signs are generally characteristic of acute respiratory infections, the complication of which is often otitis media.
• With purulent otitis media, there may be discharge from the ear canal. This indicates a perforation of the tympanic membrane.
• Permanent ear congestion or the constant presence of background noise, decreased hearing acuity, which is more characteristic of chronic otitis media.

Otitis media of the inner ear usually develops against the background of the above symptoms, which are joined by obsessive dizziness and nausea. The deterioration of health occurs rapidly, and in the absence of qualified medical care, the prognosis for the patient is unfavorable.

Diagnosis of otitis media

Diagnosis of otitis media in adults is not difficult. Unlike a small child, the patient can almost always explain that his ear hurts.This is the main diagnostic criterion.

Diagnostics is carried out in several steps:

• Taking anamnesis, that is, patient complaints. Recently transferred acute respiratory infections or acute respiratory viral infections will indicate the cause of the development of inflammation.
• Examination of the patient – otoscopy – which is performed using a special device inserted into the ear canal.
• If otitis media has become chronic, the doctor may prescribe a bacterial culture of mucus from the nasopharynx for sensitivity to antibiotics.In acute purulent otitis media, this method is practically not used, since it takes time that the patient does not have.
• If symptoms worsen or the inner ear is inflamed, skull x-rays, computed tomography and MRI are done.

Treatment of otitis media in adults

When treating otitis media, the patient is shown complete rest. Usually the following groups of drugs are used in therapy:

• Vasoconstrictor nasal drops.If, with rhinitis, doctors recommend refraining from decongestants, and rinsing the nose with sea water, then in this case, draining the mucous membrane is the key to recovery. In the absence of a runny nose, air begins to flow through the Eustachian tube, the pressure is equalized and all conditions are created to eliminate inflammation.
• Anti-inflammatory drops in the ear. Recently, many complex medicines have appeared on the market, which simultaneously contain an anti-inflammatory component, an anesthetic, and an antibiotic.It must be remembered that the use of such drops must be clinically justified, therefore it is not recommended to use them without consulting a doctor.

• Systemic antibiotics. This drug group is also used only under the strict prescription of a physician. When choosing a medicine, it is necessary to focus not only on the effectiveness of the antibiotic in terms of a specific pathogen, but also on the fact whether the medicine penetrates well into the tympanic cavity.

• Anti-inflammatory and antipyretic medications are often prescribed to relieve general symptoms.Adaptogens can also be shown to correct immunity.

Surgical methods include tympanic membrane dissection and catheterization, which are necessary in the presence of pus in the cavity. With purulent otitis media, there is always a danger that the exudate will pour out not towards the outer ear, but, on the contrary, towards the inner one.

From physiotherapeutic procedures, dry heat is used in the form of compresses (only for catarrhal otitis media) or UHF (for chronic form).

Otitis prevention

The best preventive measure is to increase general immunity and hardening. The less a patient is susceptible to acute respiratory infections, the less likely he will develop otitis media.

If it so happens that you get sick, then you need to regularly cleanse the sinuses and prevent the mucus from drying out. It is necessary to blow your nose very carefully, while freeing only one nostril.

If you have to dive in a pool or in an open pond, then before that you need to clean the external auditory canal from excess sulfur, and after swimming – drip drops with an antiseptic into your ear.If the ear is still blocked, then you need to see a doctor immediately.

Otitis media can also develop in an airplane due to pressure drops. In this case, it is necessary to take a sip of water or juice as often as possible. When swallowing, the pressure in the tympanic cavity and outside is equalized.

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What to do if a child has an ear ache

If a child has an ear ache, do not rush to the pharmacy and buy ear drops or listen to the advice of grandmothers and look for boric alcohol.The fact is that ear pain always signals a problem in a child with a hearing organ. However, ear diseases (otitis media) have a different origin. Often, parents underestimate this fact and are in no hurry to consult a pediatric otorhinolaryngologist (ENT doctor), preferring to bury drops in the child’s ear, which they will recommend at the pharmacy.

In fact, the term otitis media means several types of inflammatory diseases of the organ of hearing, depending on the localization of the inflammatory process.So with inflammation of the skin of the external auditory canal, otitis media is called external, since only the external auditory canal is involved in inflammation without affecting the middle ear.
Otitis externa is essentially dermatitis of a limited area of ​​the skin with localization in a limited area from the auricle to the tympanic membrane, at least to its first layer, covered by the epidermis.
The reasons for the development of inflammation of the external ear are infectious and allergic, predisposing factors are:

• anatomical narrowness of the ear canal,
• improper hygiene,
• foreign objects and water entering the ear, etc.

In children, otitis externa is usually diffuse (confluent) in nature, that is, the entire surface of the skin of the ear canal from the auricle to the tympanic membrane is most often affected by inflammation with the spread of edema and redness (hyperemia) to the skin of the auricle and behind the ear region.
The most characteristic sign of otitis externa is a dull, aching (and not shooting!) Pain in the ear , when trying to drip drops into the ear – they immediately flow out due to a sharp narrowing of the lumen of the external auditory canal.