Ear pain and
discomfort is a very common problem. However, not all ear
pain and discomfort comes from the ear. Over 50% of ear pain comes
from a different area. This is called "referred pain" or "referred
discomfort". An example of this is an ice cream headache.
When one swallows cold ice cream the back of the throat is cooled and
this produces "referred pain" to the forehead. Referred ear pain
can come from jaw joint (k)
spine disease or even sinusitis.
Only a medical examination of the ear and other head and neck areas can
determine the exact cause of the ear discomfort.
Itching is a common complaint. It is often associated with dry
ear canals and absent ear wax. Medically, this condition is called
Chronic Otitis Externa. This condition is often caused by an
allergy to fungus. The ear canal is a warm, dark, damp place and
fungus often grows there. Antibiotics are ineffective and the condition
has been known to last for years. Over the counter medicines,
lotrimin and tinactin solution used two to four times a day, can be
helpful. However, the best treatment I have found is filling the
ear canal with an anti-fungal cream.
Acute Otitis Externa:
This is an infection of the ear canal. It is very painful.
There is also pain when one touches the
or outer ear. Unfortunately, this condition is usually caused by a
bacteria known as pseudomonas. Oral antibiotics are usually not
effective. Ear drops must be used and the ear canal must be opened
and if possible cleaned. Opening of the ear canal is accomplished
by placing an ear wick into the ear. This allows the ear drops to
enter the ear canal and treat the infection. Not treated,
acute otitis externa
can be dangerous. This is especially true in diabetics where it
can spread and cause an infection of the soft tissues of the base of the
skull called Malignant Otitis
Acute otitis externa
is often caused by getting water in the ear or sweating in the hot sun.
Keeping the ears dry is important. Uses a hair dryer if possible.
Never place anything in the ear. A solution of 1 part white
vingear (5% acetic acid) mixed with 3 parts water is often helpful in
preventing this disorder.
Ear Wax: Never stick
anything in the ear to remove ear wax. Q-Tips will push most of
the wax further into the ear, making removal more difficult. There
are a number of over-the-counter solutions available to remove ear wax.
If these fail, consult your physician.
pressure is caused by a blockage of airflow between the
and the back of the nose. It can also be a referred sensation from
the sinuses. Patients often have allergic rhinitis (an allergic
nose) or sinusitis.
Otitis Media: This is a bacterial infection of the
space behind the eardrum). This infection is one of the most
common reason for children to visit the ear doctor. Unfortunately,
the bacterial which cause this infection are becoming more resistant to
antibiotics. Prevnar, a new vaccine,
shows promise in reducing the frequency of
acute otitis media. Left untreated,
most cases of otitis media will clear with out antibiotics, but 1 in 400 will progress to
coalescent mastoiditis, a life threatening ear infection; and rarely
meningitis, a life threatening
brain infection, can occur.
More About Acute Coalescent Mastoiditis***
Ear Drainage: This
is often a symptom of infection that the eardrum has ruptured.
Treatment with both ear drops and oral antibiotics is indicated.
In a child with ear tubes, the ear infection is often caused by water
getting into the ear canal. In this case, the infection may be
caused by pseudomonas and treatment with ear drops is strongly
This is a skin cyst which forms from the action of
pressure on the eardrum. The skin cyst erodes bone and becomes
chronically infected. If left untreated, it can eroded into the
brain (causing meningitis or a brain abscess), ear (causing deafness and
dizziness) and facial nerve (causing facial paralysis). Treatment
is imperative for all but the very small or stable cysts in high risk or
elderly patients. Surgery is required and a "mastoidectomy"
operation often needs to be performed.
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