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Conditions of the External Ear
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Ayeshah Abdul-Hamid, Samuel MacKeith
Otalgia can be primary, arising from the ear, or secondary/referred, as a result of pathology elsewhere. In children otalgia is usually otogenic; however, in adults referred otalgia is more common. The sensory supply to the ear is complex and therefore the potential origin of the referred otalgia is widely distributed, which can cause diagnostic difficulty (Figure 7.2). Otalgia in the absence of discharge, hearing loss or otoscopic abnormality should raise suspicion of referred otalgia.
Throat
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
Pain and otalgia. This is a certainty rather than a risk. Tonsillectomy is a painful operation, and the pain is often worst on the fourth or fifth day (i.e. when the patient is at home!), after which it gets better. Analgesia should be taken regularly, even if the pain is not severe, for at least a week. The patient should also be encouraged to eat and drink as normally as possible, as this prevents stiffness developing in the pharyngeal muscles. Pain may also radiate to the ear. This does not mean that the patient has an ear infection - the pain is referred.
Ear trauma
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Mechanical forces arising from pressure changes produce barotrauma. Middle ear barotrauma is the most frequent pressure-induced ear condition. Examples of large pressure changes include the rapid increase in external ear canal pressure from slap injuries typically sustained during assault, airplane descent, diving ascent or a blast injury. This can cause TM retraction, intra-tympanic membrane haemorrhage, middle ear effusion or, in severe cases, TM perforation. Symptoms include sensation of ear blockage with otalgia, which may be severe. Perilymph fistula can occasionally be caused by barotrauma and will lead to SNHL and balance disturbance. The fistula test may be positive in such cases.
Physical therapist guided active intervention of chronic temporomandibular disorder presenting as ear pain: A case report
Published in Physiotherapy Theory and Practice, 2022
Sudarshan Anandkumar, Murugavel Manivasagam
Common symptoms found in TMD include pain, stiffness, limited mouth opening or jaw deviation while opening and popping, clicking or crepitus of the joint (De Rossi, Greenberg, Liu, and Steinkeler, 2014). Apart from these symptoms, otolaryngological complaints such as ear pain, ear fullness, tinnitus, and vertigo are also linked with TMD (Kusdra et al., 2018). Ear pain (otalgia) is classified as either primary or secondary (Ely, Hansen, and Clark, 2008). Primary otalgia is caused by a pathology of the ear with the patients typically presenting with an abnormal ear examination (Ely, Hansen, and Clark, 2008). Common causes of primary otalgia include otitis media, otitis externa, and eustachian tube dysfunction (Neilan and Roland, 2010). In secondary otalgia, which accounts for about 50% of the cases, the ear is not the direct source of pathology and pain can be referred from dental or pharyngeal structures, sinuses, salivary glands, the cervical spine, or temporomandibular joint (TMJ) (Neilan and Roland, 2010).
Primary epithelioid angiosarcoma of the temporal bone with initial presentation of otalgia
Published in Baylor University Medical Center Proceedings, 2018
Di Ai, Riyam T. Zreik, Frank S. Harris, Gerhard Hill, Yuan Shan
A 57-year-old woman presented with mild to moderate otalgia without hearing loss of 9 months’ duration. Conservative treatment including antibiotics, nonsteroidal antiinflammatory drugs, and eardrops were used with no improvement. The right external auditory canal (EAC) was narrowed by a soft tissue swelling arising from the lateral/posterior aspect of the EAC. Computed tomography (CT) of the head demonstrated a 2.6 × 2.1 × 1.6cm solid and cystic mass (Figure 1) with trabecular and cortical bone destruction of the right temporal bone and extension into the anterior mastoid tip and superior aspect of the cartilaginous EAC. The solid component of the mass extended inferiorly towards the tegmen tympanum and extended through the temporal bone laterally and into the mastoid region. Magnetic resonance imaging (MRI) also demonstrated a 4.8 × 4.4 × 3.2 cm enhancing mass within the right temporal lobe with peritumoral edema and mild midline shift (Figure 2). No other masses or lymphadenopathy was seen on head, neck, and chest imaging. A right EAC biopsy was performed. Microscopically, the malignancy was composed of sheets of highly atypical epithelioid cells with poorly formed vascular channels lined by atypical epithelioid cells. Numerous mitotic figures were noted. Immunohistochemistry demonstrated focal CD31 expression along with diffuse expression of Fli-1 and ERG (Figure 3). The malignant cells were negative for CD34, GFAP, S100, inhibin, RCC, CD10, CK7, CK20, and desmin. The Ki-67 proliferation index was 80%. The biopsy was diagnosed as high-grade spindle cell neoplasm most consistent with epithelioid angiosarcoma.
Facial nerve paralysis in malignant otitis externa: comparison of the clinical and paraclinical findings
Published in Acta Oto-Laryngologica, 2020
Sasan Dabiri, Narges Karrabi, Nasrin Yazdani, Ahmad Rahimian, Azita Kheiltash, Mehrdad Hasibi, Elham Saedi
The most common clinical symptom was otalgia. Although there wasn’t any significant difference concerning the prevalence of clinical symptoms between two groups such as otalgia (p = 1.00), otorrhea (p = .13), hearing loss (p = .69), headache (p = .58), tinnitus (p = .82), vertigo (p = .14), pruritus (p = 1.00), other cranial nerve involvement (p = .15), multiple cranial nerve involvement (p = .10); but there was a significant discrepancy in terms of chief complaint (p < .01). The duration of clinical symptoms before hospitalization was 3.3 and 3.0 months in the patients with and without facial palsy, respectively.