Medihub - Medical Information - ENT

Ear pain is common and generally indicates a source of inflammation and/ or infection. Infections can affect the external or middle ear.

External ear infections are commonly the result of trauma (from digging, scratching), swimming and abuse of antibiotic ear drops. In addition, there may be discharge and deafness. The infection can involve the whole canal (diffuse) or just a hair follicle (localized). Treatment includes regular and meticulous ear cleaning (best with suction under microscopic guidance), adequate and appropriate antibiotic ear drops (including oral antibiotics if there is significant swelling) and avoidance of water (no swimming) and digging. Severe ear pain in elderly patients with diabetes mellitus should seek immediate medical attention to exclude a potentially fatal condition Malignant Otitis Externa (MOE).

Acute middle ear infections result from an upper respiratory tract infection (URTI) ascending up the Eustachian tube (a tube connecting the back of the nose to the middle ear). Children are more usually affected although the condition can be seen in adults. This is because the eustachian tube is not as well developed in children as in adults to protect the middle ear from nasal infections. Pain results from the build up of pus under pressure in the middle ear. This symptom is accompanied by deafness but no discharge if the eardrum remains intact. The patient may have other constitutional symptoms such as fever and lethargy. Examination of the ear will reveal a red and bulging ear drum. Treatment includes oral antibiotics and pain relief. If symptoms do not resolve after one week, a myringotomy (cut in eardrum) can be performed to release the pus.

Referred Otalgia
Ear pain can also result from conditions around but not involving the ear. The commonest causes of referred otalgia are temporomandibular joint dysfunction, tonsillitis, teeth and gum disorders, throat infection, tongue and thyroid problems. Treatment is targeted at the primary condition.