Otalgia
Otalgia term refers ear pain or earache.
Type of Otalgia
1. Primary otalgia; pain original inside ear
2. Secondary otalgia; Referred otalgia
3. Psychological otalgia; no cause to ear pain found.
1. Primary otalgia
Primary ear pain caused by disease in external, middle and inner ear.
External ear pain caused by;
a. Mechanical trauma
Trauma, foreign object such as; insect, cotton buds
b. Infective (otitis externa)
Staphylococcus, candida, herpes zoster or viral
Middle ear pain caused by;
1. Mechanical
Such as; Ear barotrauma, Eustachian tube obstruction cause acute otitis media.
2. Infective;
Acute otitis media, mastoiditis
2. Secondary otalgia
Secondary otalgia called referred pain to ear.
a. Via trigeminal nerve
Cranial nerve (V), trigeminal neuralgia cause otalgia.
b. Via facial nerve
Cranial nerve (Vll), due to temporomandibular joint disorder
c. Via glossopharyngeal nerve
Cranial nerve (lX), due to pharyngitis, tonsillitis.
d. Via vagus nerve
Cranial nerve (X), due to GERD (Gastroesophageal reflux disease)
e. Via 2nd and 3rd cervical vertebrae (C2, C3)
Diagnostic Evaluation
1. CBC (complete blood count)
2. Thyroid function test
3. ESR (erythrocyte sedimentation rate)
4. CT scanning and MRI
5. PET scanning
6. Audiography; test ability to hear sound in different pitches or frequencies.
7. Vestibulocochlear testing
Management
1. Antibiotics
Amoxicillin and clavulanate (Augmentin), Amoxicillin, Clarithromycin, Ciprofloxacin
2. Antiviral drugs
Acyclovir, Famciclovir, Valacyclovir
3. Antifungal drugs
Fluconazole, Nystatin
4. Antacids medication
Pantoprazole, Ranitidine
5. Analgesic
Acetaminophen
6. NSAIDs
In case of myalgia, neuralgia
7. Application of warm compress
8. Eating soft diet
9. TMJ patient should avoid chewing and hyperextension of jaw.
10. Stop teeth grinding, fitted mouth guard worn while sleeping, it prevent teeth grinding at night.
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