Otalgia is ear pain or an earache. Primary otalgia is from pain that originates inside the ear. Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm The ear is the sense organ that detects Sounds The Vertebrate ear shows a common biology from Fish to Humans with variations Referred otalgia is from 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 and infections in the nose and pharynx.

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. The middle ear is the portion of the ear internal to the Eardrum, and external to the Oval window of the Cochlea.

External ear pain may be:

• Mechanical: trauma, foreign bodies such as hairs, insects or cotton buds.
• Infective (otitis externa): Staphylococcus, Pseudomonas, Candida, herpes zoster, or viral myringitis. Staphylococcus (in Greek σταφυλη staphyle means bunch of grapes and κοκκος coccos means granule is a genus of Gram-positive Pseudomonas is a Genus of gamma Proteobacteria, belonging to the larger family of Pseudomonads Recently 16S rRNA sequence Herpes zoster (or simply zoster) commonly known as shingles, is a Viral disease characterized by a painful skin rash with Blisters in a limited (See Otitis externa)

Middle ear pain may be:

• Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media. Otitis externa ("swimmer's ear" is an Inflammation of the outer Ear and ear canal Barotrauma is physical damage to body tissues caused by a difference in Pressure between an air space inside or beside the body and the surrounding Gas or Liquid The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice The Eustachian tube (or auditory tube) is a tube that links the Pharynx to the Middle ear. Otitis media is Inflammation of the Middle ear, or middle ear infection (the word otitis is Greek and it means “inflammation of the ear” and media
• Inflammatory / infective: acute otitis media, mastoiditis. Mastoiditis is an infection of the Mastoid process, the portion of the Temporal bone of the Skull that is behind the Ear.

Secondary otalgia

Ear pain can be referred pain to the ears in five main ways:

• Via Trigeminal nerve [cranial nerve V]. The trigeminal nerve (the fifth Cranial nerve, also called the fifth nerve or simply V) is responsible for sensation in the face Rarely, trigeminal neuralgia can cause otalgia. Neuralgia is a painful disorder of the Nerves. Under the general heading of neuralgia are Trigeminal neuralgia (TN Atypical trigeminal neuralgia (ATN
• 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. The temporomandibular joint is the joint of the Jaw and is frequently referred to as TMJ. For the toad wart see Parotoid gland. The parotid gland is the largest of the Salivary glands It is found wrapped around the Mandibular ramus
• Via Glossopharyngeal nerve [cranial nerve IX]. The glossopharyngeal nerve is the ninth of twelve pairs of Cranial nerves. This comes from the oropharynx, and can be due to pharyngitis or tonsillitis, or to carcinoma of the posterior third of the tongue. The Oropharynx ( oral part of the Pharynx) reaches from the Soft palate to the level of the Hyoid bone. See also Strep throat. Pharyngitis (ˌfarɪnˈdʒʌɪtɪs is in most cases a Painful inflammation of the Pharynx, and is Tonsillitis is an Infection of the Tonsils and will often but not necessarily cause a Sore throat and Fever. A carcinoma is any Malignant Cancer that arises from epithelial cells.
• Via Vagus nerve [cranial nerve X]. The vagus nerve (ˈveɪˌgəs (VĀ-gəs (also called pneumogastric nerve or cranial nerve X) is the tenth of twelve paired Cranial nerves, and is the This comes from the laryngopharynx in carcinoma of the pyriform fossa or from the esophagus in GERD. In human anatomy the hypopharynx (or laryngopharynx) is the bottom part of the Pharynx, and is the part of the Throat that connects to the Esophagus The pyriform fossa is made up of two cavities behind the laryngeal ventricle. The esophagus or oesophagus (see American and British English spelling differences) sometimes known as the gullet, is an organ in
• Via the second and third cervical vertebrae, C2 and C3. In Anatomy, ' cervical' is an Adjective that has two meanings of or pertaining to any Neck. This ear pain is therefore postural.

Psychogenic otalgia is when no cause to the pain in ears can be found, suggesting a functional 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. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Tobacco is an Agricultural product recognized as an addictive drug processed from the fresh Leaves of plants in the genus Nicotiana. In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon ^[1]

See also

• Earwax

References

External links

• What to do if your child has earache from Seattle Children's Hospital
• Earaches - Causes, Considerations, Home Care and Prevention from Healthbasis. com