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Earache

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Definition:

An earache can be sharp, dull, or burning pain. The pain may be temporary or constant.

Alternative Names:

Otalgia; Pain - ear

Considerations:

Ear pain in children is often caused by a build-up of fluid and pressure behind the eardrum, in the area called the middle ear. The middle ear is connected to the nasal passages by a short narrow tube, the Eustachian tube. The Eustachian tube allows normal fluids to drain out of the middle ear, and helps keep the pressure in your ear equalized.

A cold or allergy can block the Eustachian tube due to inflammation and the build-up of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. When the Eustachian tube closes, the normal flow of fluid from the middle ear is prevented. The fluid begins to accumulate, which can cause stuffiness, pain, hearing loss , and an ear infection .

The symptoms of an ear infection may include fever , ear pain, fussiness, increased crying, and irritability. Many children will have temporary and minor hearing loss during and right after an ear infection. Permanent hearing loss is rare, but the risk increases the more infections a child has.

Ear pain in a child or infant is not always from infection, however. Other causes include water from bathing, soap or shampoo retention, or ear canal irritation from cotton-tipped swabs.

Ear pain in adults is less likely to be from an ear infection. What you perceive as ear pain may actually be coming from another location, such as your temporomandibular joint, your teeth, throat, or other location. This is called "referred" pain.

Common Causes:

• An object stuck in the ear or severely impacted ear wax
• An ear infection
  • Middle ear infection - acute (short and severe episode)
  • Middle ear infection - chronic (does not go away or recurs)
  • Outer ear (canal) infection - acute
  • Outer ear (canal) infection - chronic
  • Outer ear (canal) infection - malignant
• Ear injury from pressure changes (from high altitudes and other causes)
• Ruptured or perforated eardrum
• Tooth infection
• Sinus infection
• Arthritis of the jaw
• Sore throat with referred pain to the ears
• Temporomandibular joint syndrome (TMJ)

References:

American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics . 2004 May;113(5):1451-65. Review.

• Review Date: 11/8/2005
• Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Stanford School of Medicine; Lucile Packard Children's Hospital; Chief Medical Officer, A.D.A.M., Inc., and Kevin Fung, MD, FRCS(C), Department of Otolaryngology, Division of Head and Neck Oncology and Reconstructive Surgery, University of Western Ontario, London, Ontario, Canada, and Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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