Journal article
Diagnosis of ear pain
American family physician, Vol.77(5), pp.621-628
03/01/2008
PMID: 18350760
Abstract
Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary otalgia is usually apparent on examination; the most common causes are otitis media and otitis externa. The cause of secondary otalgia is often difficult to determine because the innervation of the ear is complex and there are many potential sources of referred pain. The most common causes are temporomandibular joint syndrome, pharyngitis, dental disease, and cervical spine arthritis. If the diagnosis is not clear from the history and physical examination, options include a trial of symptomatic treatment without a clear diagnosis; imaging studies; and consultation with an otolaryngologist. Patients who smoke, drink alcohol, are older than 50 years, or have diabetes are at higher risk of a cause of ear pain that needs further evaluation. Patients whose history or physical examination increases suspicion for a serious occult cause of ear pain or whose symptoms persist after symptomatic treatment should be considered for further evaluation, such as magnetic resonance imaging, fiberoptic nasolaryngoscopy, or an erythrocyte sedimentation rate measurement.
Details
- Title: Subtitle
- Diagnosis of ear pain
- Creators
- John W Ely - Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, USA. john-ely@uiowa.eduMarlan R HansenElizabeth C Clark
- Resource Type
- Journal article
- Publication Details
- American family physician, Vol.77(5), pp.621-628
- Publisher
- United States
- PMID
- 18350760
- ISSN
- 0002-838X
- eISSN
- 1532-0650
- Language
- English
- Date published
- 03/01/2008
- Academic Unit
- Molecular Physiology and Biophysics; Family and Community Medicine; Neurosurgery; Otolaryngology
- Record Identifier
- 9984006325702771
Metrics
11 Record Views