The ear is generally described in three parts: outer, middle and inner. Different conditions can affect each of these separately or can progressively involve all parts of the ear bone and its surrounding structures. Pain , especially constant or worsening pain about the ear, is a serious symptom and must be carefully assessed to exclude potentially very dangerous conditions.
Otalgia may be primary (from the ear structures themselves) or referred (from other, generally nearby, structures)
Primary causes of otalgia involving the Inner Ear are described below:
Labyrinthitis:This is the term given to inflammation of the inner ear from any cause.
Patients present with acute or recurrent dizziness, hearing loss, tinnitus and, in severe cases, pain.
-Non infectious (inflammatory, autoimmune, etc)
-Infectious (viral and bacterial)
Can be treated with pain killers, anti-inflammatories, antibiotics, steroids. In some cases nothing can be done and the illness has to be left to run its course. The ear may or may not recover, leaving the patient with deafness, tinnitus or balance disturbance.
Acoustic Neuroma/Vestibular Schwannoma:Benign tumour of the nerve of hearing and balance which presents with one sided deafness, balance disturbance, tinnitus (“ringing noises in the ear”), and in longstanding larger tumours, face weakness and headache
Facial Nerve Tumour:The facial nerve controls motion of face muscles and damage to it from any cause can result in paralysis of the face. The nerve reaches the face by passing through the ear bone.
Primary facial nerve tumours which are rare and often similar to acoustic neuromas but patients generally present with facial weakness and later hearing and balance problems. May be malignant and present with pain
Secondary facial nerve tumours which are malignant and originate from surrounding structures and patients present with facial weakness and pain
General Tumours:Generally rare malignant tumours, often spreading from other parts of the body
Petrous Apex Lesions:The petrous apex is the inner most part of the ear (temporal) bone.
A variety of rare infections, inflammations, tumours, etc can occur here and cause ear pain
Please Note: Most of the above conditions are rare and require specialised assessment, investigation and treatment.
Ear, Nose and Throat Problems may contribute to Headaches and Migraines so it is important to have them professionally addressed. It is also important to investigate for other potential causes, as many cases of Headaches and Migraines have more than one ingredient.
Author: Contact Details
Mr Anthony Guiney MBBS .FRACS
Profession: EAR NOSE THROAT, HEAD & NECK SURGEON
Address: Essendon ENT, Head and Neck Clinic
62 Buckley Street Essendon 3040
Phone: 03 9375 2099
Also consulting in Blackburn
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