Otalgia

"Earache" redirects here; see also Earache Records, a British heavy metal record label.

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

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.

Middle ear pain may be:

Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media.
Inflammatory / infective: acute otitis media (with a red tympanic membrane), mastoiditis.

Secondary otalgia

Ear pain can be referred to the ears in five main ways:

Via cranial nerve V. Rarely, trigeminal neuralgia can cause otalgia.
Via 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 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 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 alcoholAmundson LH. Disorders of the external ear]. Prim Care. 1990;17:213-231. PMID: 2196606.

External Links

What to do if your child has earache from Seattle Children's Hospital

"Otalgia". eMedicine. Retrieved Apr. 21, 2005.

References