Cause | Common Features* † | Diagnostic Approach |
---|---|---|
Middle ear | ||
Acute eustachian tube obstruction (for example, due to a cold Common Cold The common cold is a viral infection of the lining of the nose, sinuses, and throat. Many different viruses cause colds. Usually, colds are spread when a person's hands come in contact with... read more or allergies Seasonal Allergies Seasonal allergies result from exposure to airborne substances (such as pollens) that appear only during certain times of the year. Seasonal allergies cause itchy skin, a runny nose, sneezing... read more ) | Mild to moderate discomfort Gurgling, crackling, or popping noises, with or without nasal congestion Decreased hearing in affected ear | Sometimes doctor’s examination alone Sometimes audiogram |
Severe pain History of recent rapid change in air pressure (such as air travel or scuba diving) Often blood visible on or behind eardrum | Sometimes doctor’s examination alone Sometimes audiogram | |
Recent middle ear infection Redness and tenderness behind the ear Often fever and/or ear discharge | Usually a doctor’s examination alone Sometimes CT scan | |
Otitis media ( acute Otitis Media (Acute) Acute otitis media is a bacterial or viral infection of the middle ear. Acute otitis media often occurs in people with a cold or allergies. The infected ear is painful. Doctors examine the eardrum... read more or chronic Otitis Media (Chronic Suppurative) Chronic suppurative otitis media is a long-standing, persistently draining perforation of the eardrum (tympanic membrane). Causes of chronic suppurative otitis media include acute otitis media... read more ) | Severe pain, often with cold symptoms Bulging, red eardrum More common among children Sometimes ear discharge | Sometimes doctor’s examination alone Sometimes audiogram |
Infectious myringitis (eardrum infection) | Severe pain Inflamed eardrum Small blisters on surface of eardrum | Doctor’s examination alone |
Severe pain Blisters or pustules on the outer ear May be accompanied by hearing loss or facial weakness | Doctor’s examination alone | |
External ear | ||
Visible during a doctor's examination Foreign objects almost always in children | Doctor’s examination alone | |
Usually in people who were attempting to clean their ear Visible during a doctor's examination | Doctor’s examination alone | |
Otitis externa ( acute Otitis Media (Acute) Acute otitis media is a bacterial or viral infection of the middle ear. Acute otitis media often occurs in people with a cold or allergies. The infected ear is painful. Doctors examine the eardrum... read more or chronic Otitis Media (Chronic Suppurative) Chronic suppurative otitis media is a long-standing, persistently draining perforation of the eardrum (tympanic membrane). Causes of chronic suppurative otitis media include acute otitis media... read more ) | Itching and pain (more itching and only mild discomfort in chronic otitis externa) Often history of swimming or recurrent water exposure Sometimes foul-smelling discharge Red, swollen external ear canal filled with pus-like material | Sometimes doctor’s examination alone CT scan if suspected malignant external otitis (infection extending into the skull bone) |
Causes due to structures in the head and neck‡ | ||
Cancer Mouth, Nose, and Throat Cancers of the throat, tonsils, base of tongue, voice box (larynx), or nasal passages and upper throat (nasopharynx) | Chronic discomfort Often long history of tobacco and/or alcohol use Sometimes enlarged, nontender lymph nodes in the neck Usually in older people | Gadolinium-enhanced MRI Fiberoptic endoscopy with removal and examination (biopsy) of visible lesions |
Pain much worse with swallowing Visible redness of throat and/or tonsils | Sometimes doctor’s examination alone Sometimes culture | |
Neuralgia (inflamed nerve, for example, inflamed glossopharyngeal nerve Glossopharyngeal Neuralgia Glossopharyngeal neuralgia consists of recurring attacks of severe pain in the back of the throat, the area near the tonsils, the back of the tongue, part of the ear, and/or the area under the... read more ) | Very severe, frequent, sharp pains lasting less than 1 second | Doctor’s examination alone |
Pain worsens with jaw movement Lack of smooth TMJ movement | Doctor’s examination alone | |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Many people with middle and external ear disorders have some hearing loss Hearing Loss Worldwide, about half a billion people (almost 8% of the world's population) have hearing loss. More than 15% of people in the United States have some degree of hearing loss that affects their... read more . | ||
‡ A common feature is a normal ear examination. | ||
CT = computed tomography; MRI = magnetic resonance imaging. |