Otalgia: Difference between revisions
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==[[Otalgia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | ==[[Otalgia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | ||
==[[Otalgia diagnosis|Diagnosis]]== | |||
[[Otalgia diagnosis#history to be obtained|History to be obtained]] | [[ Otalgia diagnosis#physical exam|Physical Exam]] | [[Otalgia diagnosis#lab tests|Lab Tests]] | [[ Otalgia diagnosis#ecg|ECG]] | [[ Otalgia diagnosis#chest x ray|Chest X ray]] | [[Otalgia diagnosis#ct scan|CT Scan]] | [[ Otalgia diagnosis#mri|MRI]] | [[ Otalgia diagnosis#ultrasound|Ultrasound]] | [[Otalgia diagnosis#other imaging modalities|Other Imaging modalities]] | [[ Otalgia diagnosis#other diagnositc tests|Other Diagnostic tests]] | |||
==[[Otalgia treatment|Treatment]]== | |||
'''I.'''[[Otalgia diagnosis#medical therapy|Medical therapy]] | |||
'''II.'''[[Otalgia diagnosis#surgical therapy|Surgical therapy]] | |||
Revision as of 09:34, 1 July 2012
| Otalgia | |
| ICD-10 | H60 Otitis Externa H65&H66 Otitis Media H92 Otalgia |
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| ICD-9 | 380.1 Otitis Externa 381 Otitis Media 388.7 Otalgia |
| DiseasesDB | 18027 |
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Otalgia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Otalgia On the Web |
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American Roentgen Ray Society Images of Otalgia |
For patient information click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Synonyms and keywords: ear pain, earache
Overview
Pathophysiology
Epidemiology and Demographics
Risk Factors
Causes
Common Causes | System based | Alphabetical order
Natural History, Complications and Prognosis
Diagnosis
History to be obtained | Physical Exam | Lab Tests | ECG | Chest X ray | CT Scan | MRI | Ultrasound | Other Imaging modalities | Other Diagnostic tests
Treatment
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:
- Mechanical: trauma, foreign bodies such as hairs, insects or cotton buds.
- Infective (otitis externa): Staphylococcus, Pseudomonas, Candida, herpes zoster, or viral myringitis. (See Otitis externa)
Middle ear pain may be:
- Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media.
- Inflammatory / infective: acute otitis media, mastoiditis.
Secondary otalgia
Ear pain can be referred pain to the ears in five main ways:
- Via Trigeminal nerve [cranial nerve V]. Rarely, trigeminal neuralgia can cause otalgia.
- Via Facial nerve [cranial nerve VII]. This can come from the teeth (most commonly the upper molars, when it will be worse when drinking cold fluids), the temporomandibular joint (due to its close relation to the ear canal), or the parotid gland.
- Via Glossopharyngeal nerve [cranial nerve IX]. This comes from the oropharynx, and can be due to pharyngitis or tonsillitis, or to carcinoma of the posterior third of the tongue.
- Via Vagus nerve [cranial nerve X]. This comes from the laryngopharynx in carcinoma of the pyriform fossa or from the esophagus in GERD.
- Via the second and third cervical vertebrae, C2 and C3. This ear pain is therefore postural.
Psychogenic otalgia is when no cause to the pain in ears can be found, suggesting a functional 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.[1]
Laboratory Findings
- Complete blood count (CBC)
- Culture of otorrhea
MRI and CT
- Head CT scan
Other Diagnostic Studies
Treatment
- Warm compress
- Physical therapy, dental bite adjustment (TMJ)
- Remove foreign bodies with a curette
Pharmacotherapy
Acute Pharmacotherapies
- Control pain with acetaminophen, nonsteriodal anti-inflammatory drugs (NSAIDs), and topical benzocaine solution
- Antibiotics (otitis media, otitis externa, pharyngitis / tonsillitis)
- NSAIDs for TMJ
- Steroid drops, 8% aluminum acetate +/- 2% acetic acid (otitis externa)
- Antistaphylococcal antibiotics, IV antipseudomonal (malignant otitis externa)
- Decongestants (barotrauma)
See also
External links
- What to do if your child has earache from Seattle Children's Hospital
- Earaches - Causes, Considerations, Home Care and Prevention from Healthbasis.com
References
- ↑ Amundson L (1990). "Disorders of the external ear". Prim Care. 17 (2): 213–31. PMID 2196606.