Causes of Earache or Otalgia

Earache a.k.a Otalgia medically is the pain in ear that can occur due to problems within or outside the ear and may be temporary or constant. An earache can affect one or both ears and can vary from a mild, dull ache to a throbbing or stabbing pain that is nearly incapacitating.

What is referred Otalgia?
Otalgia is not always associated with ear disease. Referred otalgia is the earache arising due to disease of structures other than the ears which have common nerve connections.

Causes of Earache:

Local causes: Causes within the ear

External ear:

1. Furuncle: Staphylococcal infection of hair follicles. It is an extremely painful condition and pain occurs even while chewing and on movement of pinna.

2. Impacted wax: Ear wax that gets impacted due to poor hygiene can cause pressure and irritation of nerves causing earache.

3. Otitis externa: Infection of external ear cavity predisposed by ear picking, furuncle, mositure trapped in the ear canal (swimming, bathing) foreign bodies, etc.

4. Otomycosis: Fungal infection of the external ear caused by asperigillus and candida species of fungi. It causes extreme itching of the ear and foul smelling watery discharge from the ear.

5. Myringitis bullosa: It is characterized by formation of fluid filled bullae in external ear and eardrum. It follows infuenza epidemics.

6. Herpes zoster infection: Virus which also causes Chicken pox

7. Cancers

Middle Ear:

1. Acute otitis media: Acute infection of middle ear cavity caused by streptococcus, hemophilus and other organisms and may lead to the perforation of eardrum (tympanic membrane) resulting in hearing loss.

2. Eustachian tube obstruction: due to common cold, allergic rhinitis, nasal polyps, etc. The ventilating tube between ear and nose becomes obstructed causing pain.

3. Mastoiditis: Inflammation of mastoid air cells present in the bony structure immediately behind the pinna.

4. Aero-otitis media: a painful type of hearing loss that can result from an inability to equalize the air pressure in the middle-ear cavity when a sudden change in altitude occurs, as may happen in a rapid descent in a poorly pressurized aircraft

5. Cancers of the middle ear

Referred Causes (Causes outside the ear)

1. Dental: caries, absess, impacted molar tooth, malocclusion of teeth

2. Oral cavity: ulcers, cancers over tongue, cheek, gingiva

3. Jaw joint disorders: osteoarthritis, bruxism (developmental disorder in children where they grind teeth during sleep), dislocation

4. Neuralgias or pain arising from nerve

5. Pharynx: tonsillitis, abscess, ulcers

6. Spinal causes: Injuries to upper spine, tuberculosis causing caries spine, cervical spondiolysis

7. Others: Cancers of base of tongue, larynx, epiglottis and esophagus.

Psychogenic Causes:

Which occurs due to functional cause without any anatomical pathology.

Treatment: Underlying cause must be managed before proceeding to the specific treatment.

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