A health care professional usually diagnoses the cause of an earache by
talking to the patient, parent, or caregiver (taking history) and performing a
physical examination. In general,
X-rays and other tests are unnecessary.
The health care professional often uses an otoscope to look into the ear canal to evaluate the canal and the ear drum.
- If otitis externa is the cause of the earache, the ear canal will look swollen and inflamed. There may be thick drainage visible. Sometimes, the canal may be so swollen and painful that the diagnosis is made because of the difficulty with inserting the plastic end of the scope into the canal.
- Bullous myringitis is diagnosed by using the otoscope to visualize the ear drum.
The tissue will look inflamed and fluid blisters can be seen.
- Otitis media causes inflammation and swelling of the middle ear. The
health care practitioner cannot see the middle ear directly but instead, uses the otoscope to look at the ear drum. Initially, fluid fills the middle ear (serous otitis media), and there may be air and fluid bubbles seen behind the drum. As pressure builds, the ear drum may not move if a small puff of air is pushed through the otoscope. If the eardrum looks red and inflamed, the diagnosis of acute otitis media is made.
The health care professional also may evaluate other parts of the body including the throat (looking for
sore throat or
tonsillitis), the neck (feeling for
swollen lymph nodes and assessing stiffness), and the lungs (looking for signs of pneumonia).
- Hearing tests may be recommended if there have been recurrent
infections or if there has been a delay in speech development.
- Laboratory testing is usually not indicated in caring for routine
- Rarely, 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
necessary in most cases and usually is reserved for infections that do not respond to normal treatment.
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