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February 6, 2012
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Earache

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Earache Overview

Earache is very common medical problem for both children and adults. The pain of earache results from inflammation and swelling of the structures that make up the ear, including the external auditory canal, the tympanic membrane, and the middle ear. Myringitis is an inflammation of the tympanic membrane or ear drum.

Picture of the structures of the ear

Otitis externa is a skin infection of the outer ear canal. It is the area where was forms and often occurs after swimming (commonly referred to as swimmer's ear).

Otitis media is an infection of the middle ear and eardrum commonly seen in infants and younger children. Otitis media also may affect older children and adults.

Earache Causes

Otitis externa is commonly caused by trapped moisture in the ear canal or by minor injury to the ear canal.

Risk factors for otitis externa include:

  • Moisture trapped in the ear canal

    • The condition commonly called swimmer's ear can occur after swimming, bathing, or hot humid weather.

    • Bacteria that cause the infection are able to grow and multiply easily in the warm moist environment.

    • Rarely, the infection may be caused by a fungus.
  • Minor injury or scrape to the ear canal skin

    • This usually happens during attempts to clean the ear with objects, such as a cotton-tipped swab or paper clip. This break in the skin may allow bacteria to enter and start an infection.

Otitis media is caused by either a viral or bacterial infection of the middle ear. It often follows a cold or upper respiratory tract infection that causes inflammation of the Eustachian tube and prevents normal fluid drainage from the middle ear.

Other factors that may predispose otitis media include:

  • allergies,

  • secondhand smoke exposure,

  • bottle feeding when laying supine or flat,

  • family history of ear infections, and

  • abnormal anatomy of the head and neck area.

Myringitis, an inflammation of the ear drum may be due to localized infection or trauma.

Risk factors for myringitis include:

  • Local trauma to the ear drum may be due to puncture by a foreign object like a Qtip or paper clip used to remove wax or an insect. There may also be barotrauma, in which the ear drum is ruptured. This may occur with changes in pressure due to diving, flying in an airplane, or due to an explosion or very loud noise.

  • Bacterial and viral infections of the ear drum may cause inflammation and blistering, also known as bullous myringitis (bullous=fluid filled blister).
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Earache

Ear Infection Overview

Infection can affect the ear canal (otitis externa), the eardrum, or the middle ear (otitis media). Most ear injuries are caused by pressure changes during direct injury (such as a blow to the ear) or sport scuba diving, but, a persistently painful ear may signal an infection that requires treatment. Because an ear scope (otoscope) may not be available to examine the canal and inner ear in remote locations, starting therapy may be appropriate until a doctor can be reached.

Picture of the outer and inner structures of the ear

Ear Infection Symptoms

  • Symptoms of ear infection include:

    • ear pain,
    • fullness in the ear,

    • hearing loss,

    • ringing,
    • discharge from the ear,

    • nausea,

    • vo...

Read the Ear Infection article »


Read What Your Physician is Reading on Medscape

Otitis Media »

Otitis media (OM) is the second most common disease of childhood, after upper respiratory infection (URI).

Read More on Medscape Reference »

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