Earache

Considerations:
Ear pain is caused by a build-up of fluid and pressure in the portion of the ear behind the eardrum (called the middle ear).

The middle ear is drained by a short narrow tube (the Eustachian tube) into the nasal passages. A cold or allergy can cause the Eustachian tube to become swollen shut, especially in small children where the tube is smaller. When the Eustachian tube closes, the normal flow of fluid from the middle ear is prevented, and the fluid begins to accumulate which can cause stuffiness, pain, and hearing loss .

Ear pain is not necessarily due to a disease of the ear. Infections and other problems of the nose, mouth, throat, and jaw joint can cause pain in the ear.

When dealing with young children:
Increased irritability or pulling at the ears is often a sign of ear pain in infants. Ear infection symptoms may include fever , ear pain, fussiness, increased crying, irritability, or pulling at the ears. Ear infections are very common in infancy and childhood and are often associated with colds .

Most children will have a temporary and minor hearing loss during and right after an ear infection, but there is rarely any permanent hearing loss as long as the problem is properly managed by a health care provider.

Common Causes:

Note: This list is not all inclusive and the causes are not presented in order of likelihood. The list of all possible causes can be extensive and include unlikely diseases and medications. Furthermore, the list will vary based on the age and gender of the individual as well as on the specific characteristics of the symptom, such as location, quality, timing, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for this symptom occurring alone or in combination with other problems.

Home Care:
A vaporizer can help by adding moisture and humidity that can keep the mucus thin.

Over-the-counter analgesics can provide partial pain relief for adults with an earache.

Opening the Eustachian tube can help. Antihistamines, decongestants, or nose drops decrease the amount of nasal secretion and shrink the mucus membranes. Use these products for only a few days; if symptoms last longer than this you should consult your health care provider.

Ear pain caused by rapidly descending from high altitudes can be relieved by swallowing, chewing gum, or other methods. Allowing infants to suck on a bottle during descent can help.

Pediatric home care:

  • Give the child pain-relieving tablet or liquid (acetaminophen - oral or ibuprofen). Follow the dosage recommended on the package label.
  • Avoid cigarette smoke near the child (possible increased risk of infection).
  • If previously prescribed by the doctor, give the child eardrops for pain.
  • Apply a warm heating pad or warm water bottle to the ear to reduce discomfort.
  • If the child is uncomfortable lying down, resting in an upright position may help reduce pressure in the middle ear.
  • Avoid the use of aspirin in teenagers or children who might have the flu or chicken pox because of the risk of Reye's syndrome , which is a serious problem of the brain and liver.



Call Your Healthcare Provider If:

  • a child has an earache and discomfort is severe or lasts for longer than 2 days. All ear infections , even mild ones, require treatment.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting ear pain in detail may include:

  • time pattern
    • When did it begin?
    • Is it getting better, worse, or staying the same?
    • Is the pain constant?

  • other

Physical examination may include examination of the ear, nose, mastoid (bony part behind the ear), and throat. Pain, tenderness, or redness of the mastoid often indicates a serious infection.

Possible diagnostic tests include blood culture and sensitivity studies (if there is discharge).

Intervention:
Antibiotics and medications (such as decongestants and antihistamines) to open the Eustachian tube(s) are often prescribed. It is important to take ALL of the prescribed antibiotic on schedule.

The insertion of ear tubes may be recommended for children who have persistent otitis media in order to reestablish proper functioning of the middle ear. Inserting ear tubes is a simple and very effective procedure.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to an earache, you may want to note that diagnosis in your personal medical record.


This is an illustration of the external, middle, and inner ear. The detailed section is of the eardrum and the three tiny bones that conduct sound from the drum to the cochlea.



This is an illustration of the outside of the ear showing normal landmarks and several abnormal features including: earlobe creases, a preauricular pit, and a preauricular tag.