Ear pain can be perceived as continuous, intermittent, throbbing, rhythmic, dull, or unbearable. Contrary to popular belief, otalgia does not depend solely on ear diseases: often, in fact, earache is a secondary consequence of other conditions, such as sinusitis, tonsillitis, colds, flu, toothache, migraines. and throat cancer.
More often, moreover, the "otalgia does not remain limited to the ears: most of the time the pain s" also radiates to the nape and neck, constituting a real discomfort.
In general, two forms of ear pain can be distinguished:
- Primary Otalgia: Ear pain originates inside the organ.
- Secondary otalgia (also called "referred" otalgia): the "earache" originates "outside" and does not depend on a pathology of the ears.
CAUSES OF PRIMARY OTALGIA
Hurt in the outer ear
Bad in the middle ear
Mechanical causes
- Furuncle in the auricle
- Insertion of foreign bodies in the ear (eg marbles, games, insects, etc.)
- Plug of earwax
- Trauma to the ear
- Barotrauma (damage caused by the lack of balance between air pressure in the ear and ambient pressure)
- Obstruction of the Eustachian tube
- Residue of shampoo or soap in the ear
Infectious-inflammatory causes
- Candidiasis and otomycosis
- Staphylococcus infection
- Pseudomonas infection
- Herpes zoster infection
- Viral or bullous myringitis
- Sjögren's syndrome
- Acute otitis media
- Purulent otitis media
- Acute mastoiditis
In this sense, the triggering causes of secondary ear pain are:
- Toothache and abscess of the teeth (extremely common cause of earache), bruxism, swollen parotid: caused by lesions of the facial nerve.
- Pharyngitis, tonsillitis, nasopharyngitis, oropharyngeal carcinoma: caused by lesions of the glossopharyngeal nerve.
- Oral cavity carcinoma, trigeminal neuralgia, sinusitis, nasal obstruction: caused by lesions of the trigeminal nerve.
- Laryngopharyngitis, carcinoma of the larynx, bronchitis, esophagitis: caused by damage to the vagus nerve.
Cervical osteoarthritis, neck pain, and neck injuries can also cause ear pain.
When it is not possible to trace a precise cause, we speak of idiopathic ear pain.
, that is, with the collection of information directly from the patient. The doctor will analyze the pain intensity, duration, any difficulty swallowing, toothache, basal temperature and the patient's past history (in terms of previous illnesses).
The otoscopic examination is useful for identifying the possible causes triggering ear pain (eg otitis media, ear wax plugs, etc.). If the aforementioned diagnostic investigation does not report any satisfactory results, we proceed with the analysis and evaluation of the integrity of the cranial nerves.
For a correct diagnostic investigation, it is advisable to also examine the nose, paranasal sinuses, oropharynx, nasopharynx, parotids, larynx and trachea, to assess their state of health.
Chest x-rays and audiography may also sometimes be done for further investigation.
In the case of dysphagia, intermittent fever, lymphadenopathy, altered tone of voice and sudden weight loss, it is essential to consider the possibility of an ongoing neoplastic disease.
it must be treated with specific antibiotic therapy; the use of antiviral or antifungal drugs is recommended instead for infections sustained respectively by viruses (eg Herpes) or fungi (eg Candida, Aspergillus).Oncological ear pain should be treated with specific chemotherapy drugs and suitable treatments prescribed by the specialist.
Extremely recurrent is "otalgia dependent on flu diseases (cold, sinusitis, flu, etc.). In this case, the disorder should be treated with generic therapeutic aids, such as paracetamol (to lower fever), ibuprofen and aspirin (to reduce pain , do not give acetylsalicylic acid to children under the age of 12).
Another effective remedy to reduce ear pain is the application of hot compresses directly on the ear: the heat, in fact, reduces and relieves - albeit temporarily - the pain in the ears.
