The ear is generally described in three parts: outer, middle and inner. Different conditions can affect each of these separately or can progressively involve all parts of the ear bone and its surrounding structures. Pain , especially constant or worsening pain about the ear, is a serious symptom and must be carefully assessed to exclude potentially very dangerous conditions.
Otalgia may be primary (from the ear structures themselves) or referred (from other, generally nearby, structures)
Primary causes of otalgia involving the Middle Ear are described below:
Infection = Otitis Media
Pain, deafness and often discharge (which often results in sudden decrease in pain)
Common in young children, less common in older children and adults, often following colds, etc
Treated with antibiotics, pain killers, decongestant tablets and nasal sprays
Recurrent episodes may warrant ventilation tubes (grommets or tympanostomy tubes) which are inserted into the ear drum
Similar symptoms to acute otitis media but more prolonged course (> 3 months)
More likely to cause complications either within the ear (chronic discharge, permanent deafness, balance disturbance, facial paralysis) or outside the ear (meningitis, brain abscess, hydrocephalus, death)
Commonly associated with cholesteatoma, a condition where skin of the ear canal grows into the middle ear and slowly destroys the structures of the ear.
Quite complex surgery is often required to manage chronic otitis media
Autoimmune disease such as Wegener's Granulomatosis
Benign and malignant - not all that common
Ear drum perforation (blows to the ear, water skiing, explosive blast injuries, foreign body, etc.)
Temporal bone fractures from vehicle accidents (somewhat obvious!)
Ear, Nose and Throat Problems may contribute to Headaches and Migraines so it is important to have them professionally addressed. It is also important to investigate for other potential causes, as many cases of Headaches and Migraines have more than one ingredient.
See Treatments Section
Keywords: pains, ear, earpain, otitis media, otitis, otitis externa, ear pain, inner ear pain, ear infections, ear nose and throat surgeon, maxillofacial specialist, ear surgeon, ent specialist
Author:Mr Anthony J. Guiney MBBS FRACSEar, Nose, Throat, Head & Neck Surgeon