Ear Pain

Clinical Presentations » Otalgia

Definition ≡ Pain in or around the ear

Introduction

Common. primary vs secondary otalgia.

History

• detailed history helps differentiate between primary vs secondary causes and narrows differential
• onset, duration, quality of pain
• associated symptoms in otologic (primary) otalgia: purulent otorrhea, decreasing hearing, previous ear surgery
• associated symptoms in secondary otalgia: voice change, mastication or swallowing pain, purulent rhinorrhea

Physical Exam

• complete physical exam with a thorough head and neck exam including otoscopy (special emphasis on ear, upper aerodigestive tract, dental structures, neck and cranial nerves, TMJ)
• mild inflammation in external and middle ear do not rule out referred otalgia

Differential Diagnosis of Otalgia

Primary

Secondary

Indications for Referral

• Any focal mucosal lesion, asymmetrical ulceration or masses in aerdigestive tract require further investigation and biopsy.
• Any focal neurological deficit noted during physical exam