Otalgia: what is it, causes, symptoms, treatment

What is Otalgia?

OtalgiaIs an ear pain that usually occurs in only one ear. Some people also have ear discharge or, in rare cases, have hearing loss.

Causes and risk factors

Otalgia may be due to a disorder within the ear itself or a disorder in the adjacent part of the face through which the same nerves pass to the brain. These organs and parts of the face include the nose, sinuses, throat, and temporomandibular joint (TMJ).

The most common causes of acute pain (lasts less than 2 weeks) are:

• middle ear infection (otitis media);
• external ear infection (otitis externa);
• a sharp change in pressure (barotrauma).

Middle and outer ear infections cause painful inflammation. A middle ear infection also causes an increase in pressure behind the eardrum. This increase in pressure not only causes pain, but also causes the tympanic membrane to protrude. If the eardrum bulges out, it may burst suddenly and a small amount of pus and / or blood comes out of the ear. In some cases, a middle ear infection spreads to the mastoid process behind the ear (causing mastoiditis).

In patients with diabetes or impaired immune system (due to HIV infection or chemotherapy for cancer treatment), especially severe forms of external otitis media - malignant or necrotizing otitis externa.

Changes in pressure during airplane flight and diving can cause discomfort. This ear pain occurs when the tube that connects the middle ear to the back of the nose (the Eustachian tube) becomes clogged or cannot function properly. Blockage or dysfunction prevents the pressure in the middle ear from equalizing with the external pressure. The pressure drop pushes or pulls on the eardrum, causing pain. Changes in pressure can rupture the eardrum.

The most common reasons for the appearance chronic pain (lasts longer than 2-3 weeks) are:

• temporomandibular joint disease;
• chronic dysfunction of the Eustachian tube;
• chronic external ear infection.

A less common cause of chronic pain is pain due to diseases affecting the larynx (vocal apparatus), including cancer (radiating [reflected] pain).

Survey

The information below will help people with anotalgia decide when to see a doctor and what happens during the test.

- Warning signs.

For people with ear pain, the following symptoms and signs are cause for concern:

• diabetes or a weakened immune system;
• redness and swelling behind the ear;
• severe swelling at the entrance to the ear canal;
• discharge of fluid from the ear;
• chronic pain, especially if there are symptoms in other organs of the head / neck (eg, hoarseness, difficulty swallowing or nasal congestion).

- When to see a doctor?

If you have warning signs or discharge from the ear, see your doctor right away. The exception is when chronic pain is the only symptom. In such a case, delaying for a week is usually not harmful. Patients with acute pain should see a doctor within a few days (or sooner if the pain is severe).

- What does the doctor do?

Doctors first ask the patient about their symptoms and medical history. The doctor then performs a physical exam, which focuses on the ears, nose, and throat. Information from the history and physical examination often indicates the cause of the pain in the ear and the tests that may be needed.

In addition to warning signs, ear exam results are important. Diseases of the middle and outer ear cause abnormalities that, when combined with symptoms and medical history, usually indicate the cause.

If no changes were found during the ear examination, the patient's otalgia may be caused by another apparent cause, such as tonsillitis. If no abnormalities were found during the ear examination, but the patient complains of chronic pain, doctors sometimes suspect that otalgia may be related to temporomandibular disease joint. However, patients with chronic pain should undergo a complete head and neck examination (including examination with using fiber optic devices) to rule out cancer or malignant growth in the nasal passages and upper throat (nasopharynx).

- Diagnostics.

The diagnosis is usually made based on the results of the examination carried out by the doctor. Additional examination is not required. However, if no abnormalities are found during the examination, and the patient complains of chronic otalgia, tests should be carried out to detect cancer. Such examinations typically include examining the nose, throat, and vocal apparatus (larynx) with a flexible optical tube (endoscope) and magnetic resonance imaging (MRI) of the head and neck.

Otalgia treatment

The best treatment for otalgia is to treat the underlying condition.

Oral pain medications may be prescribed to patients. Usually, non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen give the desired effect. However, some patients, especially those with a serious external ear infection, may need to take opioids such as oxycodone or hydrocodone for several days. If you have a serious external ear infection, your doctor will usually suck pus or other discharge from your ear canal and insert a small wick. The wick is moistened with antibiotic and / or corticosteroid ear drops.

Ear drops containing pain relievers (such as an antipyrine / benzocaine combination) are usually not very effective, but can be used for several days. These drops (like any other ear drops, including earwax drops) should not be used if the eardrum is perforated. Therefore, patients whose eardrum may be perforated should consult a physician.

Do you know that…

Avoid picking a foreign object in your ears, no matter how soft it seems.

You should not pick in your ears with any foreign objects (no matter how soft the object seems or how neat the person thinks he is). Do not try to clean your ears yourself. This can only be done on the recommendation of a doctor and very carefully. An oral irrigator (used to clean your teeth) should never be used to clean your ears.