Otalgia

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Otalgia
ICD-10H60 Otitis Externa H65&H66 Otitis Media H92 Otalgia
ICD-9380.1 Otitis Externa 381 Otitis Media 388.7 Otalgia
DiseasesDB18027
MedlinePlus003046
eMedicineent/199
 
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Otalgia
ICD-10H60 Otitis Externa H65&H66 Otitis Media H92 Otalgia
ICD-9380.1 Otitis Externa 381 Otitis Media 388.7 Otalgia
DiseasesDB18027
MedlinePlus003046
eMedicineent/199

Otalgia or an earache is ear pain. Primary otalgia is ear pain that originates inside the ear. Referred otalgia is ear pain that originates from outside the ear.

Otalgia is not always associated with ear disease. It may be caused by several other conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, throat cancer, and occasionally as a sensory aura that precedes a migraine.

Contents

Primary otalgia

Ear pain can be caused by disease in the external, middle, or inner ear, but the three are indistinguishable in terms of the pain experienced.

External ear pain may be:

Middle ear pain may be:

Secondary (referred) otalgia

The neuroanatomic basis of referred otalgia rests within one of five general neural pathways[1] The general ear region is sensorily innervated via four cranial nerves and two spinal segments. Hence, pathology in other "non-ear" parts of the body innervated by these neural pathways may "refer" pain to the ear. These general pathways are:

In an adult with chronic ear pain, yet a normal ear on exam, the diagnosis is carcinoma of the head and neck region until proven otherwise. Yet some patients will have a "psychogenic otalgia," and no cause as to the pain in ears can be found (suggesting a psychosomatic origin). The patient in such cases should be kept under observation with periodic re-evaluation.

Diagnosis

It is normally possible to establish the cause of ear pain based on the history. It is important to exclude cancer where appropriate, particularly with unilateral otalgia in an adult who uses tobacco or alcohol.[2] Often migraines are caused by middle ear infections which can easily be treated with antibiotics. Often using a hot washcloth can temporarily relieve ear pain.

Children

It's not unusual for an ear infection to develop in early childhood. Although they're not contagious, ear infections can occur as side effects of contagious illnesses—colds, coughs, or eye ailments like conjunctivitis.[3]

See also

References

  1. ^ Scarbrough TJ; Day, TA; Williams, TE; Hardin, JH; Aguero, EG; Thomas Jr, CR (2003). "Referred otalgia in head and neck cancer: a unifying schema". American Journal of Clinical Oncology 26 (5): e157–62. doi:10.1097/01.coc.0000091357.08692.86. PMID 14528091. 
  2. ^ Amundson L (1990). "Disorders of the external ear". Prim Care 17 (2): 213–31. PMID 2196606. 
  3. ^ Institute for Good Medicine at the Pennsylvania Medical Society, http://www.myfamilywellness.org/MainMenuCategories/FamilyHealthCenter/AntibioticResistance/Earaches.aspx, 2009.

External links