EARACHE

Ear pain (otalgia) is a very common problem, particularly in children, and because the pain is often caused by a
build-up of pressure  inside  the middle ear, normal  (and even prescribed) painkillers are often not effective. Only
reducing the pressure will ease the pain.
It  is often difficult  to  tell  if a child has an ear  infection, but  this  trick may help.  If moving  the outer ear causes
pain, a middle ear infection is a possibility. If pressure on the tragus (the firm lump of cartilage immediately in front
of the ear canal) causes pain, an outer ear infection is possible. If neither causes pain, an ear infection is unlikely.
A direct  injury  to  the ear  from a blow or  fall may  cause bleeding, bruising,  swelling and pain  to  the ear and
surrounding tissues.
Wax is normally produced in the ear canal by specialised glands, and slowly moves out of the canal  to keep it
clean. If excess amounts of wax are produced, dirt or dust gets into the canal, water swells the wax in the canal, or
attempts are made to clean the canal with a cotton bud or other implement, the wax may become swollen, hard and
tightly packed in the canal to cause pain and deafness.
Otitis externa (swimmer's ear) is a bacterial or fungal (tropical ear) infection of the ear canal. The ear becomes
very painful, and as the infection progresses, a smelly discharge usually develops.
Middle  ear  infections  (otitis media)  are  a  very  common  cause  of  temporary  deafness  in  children  that  if  left
untreated, may progress to a permanent partial loss of hearing. The ear is painful, the child is feverish, and when a
doctor examines the ear, a red bulging eardrum can be seen.
If  phlegm  from  the  nose  enters  the  middle  ear  cavity  through  the  Eustachian  tube,  or  other  secretions
accumulate in the cavity, it is difficult for them to escape back through the Eustachian tube to the back of the nose,
particularly if the adenoids which surround the opening of the tube into the nose are swollen. This is glue ear, and may be responsible for recurrent infections in the ear, deafness and low-grade ear discomfort.
A  Eustachian  tube  blocked  with  phlegm  will  prevent  pressure  equalisation  between  the middle  ear  and  the
outside  if  there  is an altitude change  (eg.  taking off  in an aircraft) or pressure change  (eg. scuba diving).  Intense
pain will be felt in the ear because of distortion of the sensitive eardrum with the pressure difference. In the worst
cases, the eardrum will burst, the pain will ease, but the ear will be deaf until the ear drum heals.
If bacteria or viruses enter the sinuses, an infection (sinusitis) may result and thick pus is produced. The sinuses
becomes very painful and tender, then waste products from the infection enter the blood stream, and cause a fever,
headaches and  the other unpleasant sensations of any major  infection.  It  is quite easy  for  the  infection  to spread
through the Eustachian tube from the back of the nose to the middle ear.
The common cold (coryza) may be caused by one or more of several hundred different viruses. It may cause a
sore throat, runny nose, cough, fever, headache, earache and general tiredness.
The sensory nerves  that supply  the  teeth  run along  the  top and bottom  jaws  to a point  just  in  front of  the ear
where they enter the skull. Any infection or disease of a tooth can inflame the nerve running from that tooth, but the
pain may be felt in the ear because of the course the nerve follows to the brain. Babies who are teething often pull
at their ears because of this phenomenon.
Less  common  causes  of  earache  include  a  foreign  body  in  the  ear  canal  (eg.  a  small  toy,  nut,  insect),
mastoiditis (infection in the bone behind the ear), a furuncle (boil in the ear), a cholesteatoma  (foul smelling growth
in the ear canal), and parotitis (infection of the parotid salivary gland).
 There are many uncommon and rare causes of ear pain.