Symptom Finder - Earache
EARACHE
The analysis of earache is much like that of dysuria: It is anatomic, and inflammation accounts for the vast majority of causes. Thus, otitis externa would be like urethritis, otitis media like cystitis, and so forth.
Like cystitis, otitis media is often initiated by obstruction (e.g., swollen adenoids). Foreign bodies in the ear, like foreign bodies in the bladder, must always be looked for. Unlike dysuria, earache is often caused by referred pain. Thus, parotitis (e.g., mumps), temporomandibular joint (TMJ) syndrome, pharyngitis, and dental caries or abscesses may cause earache.
Approach to the Diagnosis
The approach to the diagnosis requires ear, nose, and throat examination; culture of any discharge; and x-ray film of the mastoids, petrous bone, TMJs, and in some cases, the sinuses and teeth. A careful neurologic examination is necessary in unexplained otalgia. Referral to an otolaryngologist or neurologist is probably best for the busy physician who is unable to find the cause on a routine examination.
Other Useful Tests
1. Computed tomography (CT) scan of the mastoids (mastoiditis)
2. Magnetic resonance imaging (MRI) of the TMJs (TMJ syndrome)
3. Throat culture (streptococcal pharyngitis)
4. X-ray of the teeth (dental abscess)
5. Impedance tympanogram (otitis media)
6. Audiogram (otitis media)
7. SPECT scan (TMJ syndrome)
The analysis of earache is much like that of dysuria: It is anatomic, and inflammation accounts for the vast majority of causes. Thus, otitis externa would be like urethritis, otitis media like cystitis, and so forth.
Like cystitis, otitis media is often initiated by obstruction (e.g., swollen adenoids). Foreign bodies in the ear, like foreign bodies in the bladder, must always be looked for. Unlike dysuria, earache is often caused by referred pain. Thus, parotitis (e.g., mumps), temporomandibular joint (TMJ) syndrome, pharyngitis, and dental caries or abscesses may cause earache.
Approach to the Diagnosis
The approach to the diagnosis requires ear, nose, and throat examination; culture of any discharge; and x-ray film of the mastoids, petrous bone, TMJs, and in some cases, the sinuses and teeth. A careful neurologic examination is necessary in unexplained otalgia. Referral to an otolaryngologist or neurologist is probably best for the busy physician who is unable to find the cause on a routine examination.
Other Useful Tests
1. Computed tomography (CT) scan of the mastoids (mastoiditis)
2. Magnetic resonance imaging (MRI) of the TMJs (TMJ syndrome)
3. Throat culture (streptococcal pharyngitis)
4. X-ray of the teeth (dental abscess)
5. Impedance tympanogram (otitis media)
6. Audiogram (otitis media)
7. SPECT scan (TMJ syndrome)
