Ear pain (otalgia) is a symptom of otitis media, eustachitis, foreign bodies entering the ear canal. Soreness also occurs with injuries of the ear, temporal bone, benign and malignant tumors, neurological diseases. To diagnose the causes of pain syndrome, otoscopy, audiometry, radiography and computed tomography of the skull are performed. Analyzes of discharge from the ear, blood tests help to establish the origin of the symptom. To relieve pain, local drugs (ear drops) and systemic analgesics are used. Treatment includes medication and physiotherapy, if necessary, resort to otosurgery.
Ear inflammation is the most common cause of soreness in children and adults. Depending on the location and degree of damage, pain can be shooting, dull, throbbing or arching. Usually the discomfort is felt on one side, but bilateral inflammation is also possible. The symptom is combined with headache, malaise, fever. Otalgia manifests various variants of the inflammatory process:
Swimmer's ear syndrome (external diffuse otitis media) occupies a separate place among the causes of pain. Otalgia is the main symptom of pathology. Pulsating or shooting pains predominate, aggravated by pressure on the affected area, pulling the earlobe. Patients also complain of discomfort and bursting in the external ear canal, hearing loss.
For inflammation of the auditory (Eustachian) tube, dull pain and discomfort on the side of the lesion are typical. Patients describe their symptoms as a feeling of fluid transfusion in the ear, unpleasant swelling or congestion. Severe otalgia is observed with eustachitis caused by sudden changes in atmospheric pressure. A specific symptom of the disease is autophony - a feeling of resonance of one's own voice in the ear.
Earache
When large objects get into the ear canal, patients are worried about arching severe pain, which is felt constantly and does not decrease after the use of drops or painkillers. If the foreign body has sharp edges, in addition to the pain syndrome, bleeding from the ear opens or pain occurs sharply due to damage to the eardrum.
In addition to these symptoms, patients notice ear congestion, unilateral hearing loss. Less common are dizziness and headaches. If the object is in the ear for a long time, an inflammatory process begins, in which the otalgia intensifies, the pain becomes shooting or throbbing. Mucopurulent exudate is released from the ear canal.
When the auricle is damaged, sharp pains occur on the affected side, which over time are replaced by dull or pulsating (during the formation of a hematoma). If the injury affects the auditory canal, in addition to severe pain, there is bleeding and hearing loss by the type of conductive hearing loss. Damage to the eardrum is characterized by a strong pain syndrome, which gradually subsides, is replaced by hearing loss and congestion.
Injuries of the middle and inner ear are often found in the structure of TBI, which determines the features of clinical symptoms. Patients complain of excruciating pains that capture not only the ear, but also the temporal region, the mastoid process. Severe injuries cause excruciating headache without a clear localization. Typically, ear bleeding, a sharp decrease or lack of hearing.
Benign neoplasms are accompanied by otalgia only when they reach a significant size and squeezing the surrounding tissues. If the tumor is located near the eardrum, the patient is worried about tinnitus, hearing loss. Burning pains are pathognomonic for malignant tumors. Soreness at first is of a periodic nature, as the tumor grows, the intensity of the pain syndrome steadily increases.
With mumps, pain is localized mainly in the parotid region, the projection zone of the affected salivary glands. Usually the pain syndrome spreads to the ear. According to the clinical picture, the infection may resemble otitis media or eustachitis. Otalgia is felt stronger when chewing and talking, feeling the affected area, the skin over which becomes stretched and shiny. The most intense arching pains occur at night.
Neuralgia of the ear node is manifested by bouts of burning or throbbing unilateral pain, which is localized in the ear, as well as the area adjacent to it. Pain radiates to the back of the head, neck, temporomandibular joint. An attack of otalgia lasts from several minutes to one hour, after which all symptoms disappear. Paroxysms are provoked by a change in temperature and humidity, changes in barometric pressure.
With neuralgia of the glossopharyngeal nerve, the pain is localized mainly in the root of the tongue, but often it radiates to the ear. The pain attack is associated with chewing, coughing, eating too hot or cold food. Otalgia is also noted with ganglionitis of the geniculate node, which develops as part of a herpes infection (Ramsay Hunt syndrome). Moderate dull pain in the ear occurs with cochlear neuritis.
With the use of drugs with an ototoxic effect, dull pains occur, often intermittent. Simultaneously with otalgia, ringing, noise and whistling in the ears disturb, hearing worsens. Unpleasant symptoms are aggravated by tilting the head in different directions, sharp turns of the body. Iatrogenic ototoxicity is most often manifested by aminoglycosides, loop diuretics, and platinum derivatives.
With complaints of otalgia, you should consult an otolaryngologist. A preliminary diagnosis is already made during a visual examination, when signs of injury to the outer ear, suppuration or liquorrhea, and tumor-like outgrowths in the ear canal are found. To establish the cause of pain, the examination scheme includes informative instrumental and laboratory diagnostic methods:
Otoscopy for ear pain
Ear drops with local anesthetics or oral tablets with analgesics are used to reduce earache before a visit to the doctor. Medicines can be used if the pain does not occur due to an injury. The bones of the skull and the brain are quickly involved in the pathological process that affected the ear, so self-treatment is unacceptable. Assistance to patients with otalgia should be a qualified ENT doctor.
Treatment involves the use of topical or systemic drugs, or a combination of both. For otitis, ear drops containing antibacterial, anti-inflammatory and anti-allergic substances are used, an ear toilet is performed. To improve the outflow of exudate from the tympanic cavity, vasoconstrictors are instilled into the nose. To reduce the pain syndrome in the first days (before the eardrum breaks), heated 96% alcohol is dripped into the ear.
To eliminate the consequences of taking ototoxic drugs, ATP and galantamine are prescribed, which stimulate regeneration processes. Nootropics help to improve the nutrition of the structures of the auditory analyzer. To act on the neurological causes of otalgia, sedatives, anticholinergics, metabolic and vasoactive drugs are recommended. Severe pain paroxysms require the use of anticonvulsants.
In practical otolaryngology, methods of physiotherapy are effective. To stop the inflammatory process and stimulate local immunity, microwave therapy, laser therapy, and UHF are performed. For the prevention of hearing impairment in the recovery period, pneumomassage of the tympanic membrane is performed. Reflexology, amplipulse therapy helps to eliminate paroxysms of neuralgia of the ear node.
The tympanic cavity is cleared of pus during myringotomy, followed by washing the ear with antibacterial solutions. In chronic otitis media and the absence of the effect of conservative measures, anthrodrainage is performed in the area of the mastoid process. Indications for surgical treatment are external cholesteatoma, exostoses, abscesses.
To eliminate the consequences of a middle ear injury, reconstructive surgeries are prescribed: myringoplasty, tympanoplasty, mastoidoplasty. In case of damage to the inner ear, otosurgical interventions are performed to restore the integrity of the anatomical structures. In severe illnesses and injuries accompanied by hearing loss, the patient needs a hearing aid fitting or cochlear implantation.