Otalgia

Otalgia
Otalgia
ICD-10 H60 Otitis Externa H65&H66 Otitis Media H92 Otalgia
ICD-9 380.1 Otitis Externa 381 Otitis Media 388.7 Otalgia
DiseasesDB 18027
eMedicine ent/199

Otalgia or an earache is ear pain. Primary otalgia is ear pain that originates inside the ear. Referred otalgia is ear pain that originates from outside the ear.

Otalgia is not always associated with ear disease. It may be caused by several other conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, throat cancer, and occasionally as a sensory aura that precedes a migraine.

Contents

Primary otalgia

Ear pain can be caused by disease in the external, middle, or inner ear, but the three are indistinguishable in terms of the pain experienced.

External ear pain may be:

Middle ear pain may be:

Secondary (referred) otalgia

The neuroanatomic basis of referred otalgia rests within one of five general neural pathways [1] The general ear region is sensorily innervated via four cranial nerves and two spinal segments. Hence, pathology in other "non-ear" parts of the body innervated by these neural pathways may "refer" pain to the ear. These general pathways are:

  • Via Trigeminal nerve [cranial nerve V]. Rarely, trigeminal neuralgia can cause otalgia. Oral cavity carcinoma can also cause referred ear pain via this pathway.
  • 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 oropharynx (base of tongue, soft palate, pharyngeal wall, tonsils).
  • Via Vagus nerve [cranial nerve X]. This can arise from the laryngopharynx in carcinoma of the this area, or from the esophagus in GERD.
  • Via the second and third spinal segments, C2 and C3.

In an adult with chronic ear pain, yet a normal ear on exam, the diagnosis is carcinoma of the head and neck region until proven otherwise. Yet some patients will have a "psychogenic otalgia," and no cause as to the pain in ears can be found (suggesting a psychosomatic origin). The patient in such cases should be kept under observation with periodic re-evaluation.

Diagnosis

It is normally possible to establish the cause of ear pain based on the history. It is important to exclude cancer where appropriate, particularly with unilateral otalgia in an adult who uses tobacco or alcohol.[2] Often migraines are caused by middle ear infections which can easily be treated with antibiotics. Often using a hot washcloth can temporarily relieve ear pain.

Children

It's not unusual for an ear infection to develop in early childhood. Although they're not contagious, ear infections can occur as side effects of contagious illnesses—colds, coughs, or eye ailments like pinkeye.[3]

See also

References

  1. ^ Scarbrough TJ; Day, TA; Williams, TE; Hardin, JH; Aguero, EG; Thomas Jr, CR (2003). "Referred otalgia in head and neck cancer: a unifying schema". American Journal of Clinical Oncology 26 (5): e157–62. doi:10.1097/01.coc.0000091357.08692.86. PMID 14528091. 
  2. ^ Amundson L (1990). "Disorders of the external ear". Prim Care 17 (2): 213–31. PMID 2196606. 
  3. ^ Institute for Good Medicine at the Pennsylvania Medical Society, http://www.myfamilywellness.org/MainMenuCategories/FamilyHealthCenter/AntibioticResistance/Earaches.aspx, 2009.

External links


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Synonyms:

Look at other dictionaries:

  • otalgia — f. otorrin. Dolor de oído, que puede ser causado por algún tipo de afección en la articulación temporomandibular, en los dientes, la faringe o en el propio oído. También se denomina otidinia. Medical Dictionary. 2011. otalgia …   Diccionario médico

  • otalgia — (n.) 1650s, from Gk. otalgia ear ache, from ous, aus ear (see EAR (Cf. ear) (1)) + algos pain (see ALGIA (Cf. algia)) …   Etymology dictionary

  • otalgia — [ō tal′jē ə, ō tal′jə] n. [ModL < Gr ōtalgia: see OTO & ALGIA] an earache; pain in the ear …   English World dictionary

  • Otalgia — O*tal gi*a, n. [NL., fr. Gr. ?; o y^s, wto s, the ear + a lgos pain: cf. F. otalgie.] (Med.) Pain in the ear; earache. [1913 Webster] …   The Collaborative International Dictionary of English

  • otalgia — s. f. [Medicina] Dor nos ouvidos.   ‣ Etimologia: oto + algia …   Dicionário da Língua Portuguesa

  • otalgia — sustantivo femenino 1. (no contable) Área: medicina Dolor de oídos …   Diccionario Salamanca de la Lengua Española

  • otalgia — (Del gr. ὠταλγία). f. Med. Dolor de oídos …   Diccionario de la lengua española

  • otalgia — (Del gr. us, otos, oreja + algos, dolor.) ► sustantivo femenino MEDICINA Dolor de oídos. * * * otalgia (del gr. «ōtalgía») f. Med. *Dolor de *oído. * * * otalgia. (Del gr. ὠταλγία). f. Med. Dolor de oídos. * * * ► …   Enciclopedia Universal

  • otalgia — otalgic, adj. /oh tal jee euh, jeuh/, n. Pathol. earache. [1650 60; < NL < Gk otalgía, equiv. to ot OT + algia ALGIA] * * * …   Universalium

  • otalgia — SYN: earache. [ot + G. algos, pain] geniculate o. SYN: geniculate neuralgia. reflex o. pain referred to the ear from disease in another part, most commonly teeth, maxillary sinus …   Medical dictionary

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