EARACHE
It is also known as OTALGIA. This is the most
common complaint found in children and adults. It is not always
associated with ear disease. It may be caused by several other
conditions, such as impacted teeth, sinus disease, inflamed tonsils and
infections in the nose and pharynx.
This may due to diseases of external, middle and inner ear.
Causes:
1.External ear- a. foreign body in auditory canal like insect, cotton
bud, etc.
a.Impact moisture in auditory canal.
b.Inflammation of external ear (otitis externa) due to infection.
2.Middle ear- a. Infection of middle ear (otitis media). The most
common cause is infection of
upper
respiratory tract. The Eustachian tube which connect the pharynx to
middle ear transmits
the infection.
b. Mechanical Trauma- barotrauma (often iatrogenic),
Eustachian tube obstruction leading to
acute otitis media.
c. Allergies.
d. Family history of ear infection.
3.Ear pain can be referred pain to the ears in five main ways:
- Via Trigeminal nerve [cranial nerve V]. Rarely, trigeminal
neuralgia can cause otalgia.
- Via Facial nerve [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 Glossopharyngeal nerve [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 Vagus nerve [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 earache 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.
Symptoms:
1.Otitis externa-
a.the pain is severe in intensity, worsen by pulling and touching ear.
b.Hearing loss.
c.Ringing and buzzing sound in ear.
d.Sensation of fullness in the ear.
e.Swelling of extrnal ear.
f.Thick drainage of ear.
2.Otitis media-
a.Pain in ear.
b.Hearing loss.
c.Plugged or full sensaton in the ear.
d.Fever
e.Discharge from ear that coming out after rupture of eardrum.
f.Ringing and buzzing in the ear.
g.Other symptoms- nausea and vomiting, irritability, etc.
Investigation:
A physician diagnoses otitis externa or otitis media after examining
the ear with an instrument called an otoscope. In general, x-rays and
other tests are unnecessary.
1.Otoscopy
2.Hearing test for otitis media
3.Laboratory tests in otitis externa
>>Sometimes, a sample of drainage from the
ear is sent to the laboratory in an attempt to identify the specific
bacteria causing the infection.
>>Sending the sample to the laboratory is
not needed in most cases and usually is reserved for infections that do
not respond to normal treatment.
Management:
1. If there is a high fever or severe pain for an ear infection or new
symptoms appear,
like dizziness, severe headache,
swelling around the ear, weakness of the face muscles,
severe pain suddenly stops; this may be a sign of
a ruptured eardrum and symptoms (pain,
fever, or irritability) get worse or do not
improve within 24 - 48 hours then patient should
consult a specialist.
2. Homoeopathy-People who regularly suffer form ear aches and ear
infections already know
that it is possible for the body to
develop immunity to the antibiotics that are regularly prescribed to treat them. They should therefore, turn to homoeopathy for help in treating cases of earache. They will surely be satisfied!
3. Prevention- The following steps can help prevent earaches:
- Avoid smoking near children. Smoking has been shown to
cause millions of ear infections each year in children.
- Prevent outer ear infections by not putting objects in the
ear, and drying the ear after bathing or swimming.
- Take steps to control allergies. In particular, avoid
allergy triggers. Steroid nasal spray may help reduce ear infections.
However, over-the-counter sedating antihistamines and decongestants do
NOT prevent ear infections.
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