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ENT
(Common Ear, Nose, Throat Problems)
Having Pain In the Ear
Earache can be due to causes locally in the ear or referred from
other areas.
Common Local causes
| A. |
Boil
in the ear :- Severe pain in the ear; increased pain on
moving the pinna & jaw
Analgesics and Antibiotics will be required.
|
| B. |
Impacted
wax :-In some people excessive wax may be secreted and deposited
as a plug in the ear canal leading to decreased hearing
and pain.
It has to be removed by syringing or instrumental manipulation.
Hard wax may require softening with wax solvents before
removal. |
| C. |
Infection
of the ear canal ( otitis externa ) :- Excessive scratching
of the ear canal with match sticks or hair pins leads to
trauma in the ear canal and to subsequent infection.
Systemic causes: Antibiotics taken orally and local application
of drops may be required. |
| D. |
Otomycosis
( Fungal infection) :- You may have intense itching in the
ear and discomfort due to watery discharge .This is a condition
seen commonly in swimmers. Antifungal drops may be required. |
| E. |
Foreign
body in the ear :- Children are notorious for putting all
sorts of things in their ears. The common objects being
pieces of paper, seeds, chalk pieces, beads, ball bearings,
broken pieces of match stick, cotton.
Doctoring should be avoided at home and an ENT specialist
should be consulted. |
| F. |
Acute
Suppurative Otitis Media (ASOM) :- It is an acute inflammation
of middle ear by pus causing bacteria. This condition is
commonly seen in infants and children. Factors interfering
with normal functioning of eustachian tube(the canal connecting
the ear to the oral cavity) predispose to ASOM.
Common predisposing factors for ASOM are :
Recurrent attacks of common cold, upper respiratory tract
infections, Measles, Diphtheria.
Infection of the tonsils
Chronic infection of sinuses
Nasal allergy
Feeding a young infant in horizontal position may force
fluids through the eustachian tube into the middle ear so
they should always be nursed in a position where the head
is slightly raised.
Initial complaints consist of deafness and/or mild earache
if tube occlusion is prolonged .When earache becomes severe,
it is associated with fever, decreased hearing and ringing
sensation in the ears. The symptoms might subside with rupture
of the ear drum and release of pus, or they may lead to
complaints of giddiness, vomiting, tenderness behind the
ear, high fever and so on.
An E.N. T specialist should be consulted in the early stages
when there is mild earache. Antibacterial therapy, decongestants
and antipyretics are needed. A minor surgery which involves
incising the ear drum and releasing the pus may be necessary
in a few cases.
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| G. |
Trauma
to the ear. A slap on the ear or very loud noise can cause
traumatic rupture of the tympanic membrane(ear drum) and
pain in the ear with decreased hearing.
Ear should be examined and appropriate treatment instituted.
Other causes for pain in the ear
| • |
Carious tooth |
| • |
Impacted molar |
| • |
Osteoarthritis of the Temporomandibular
joint |
| • |
Acute tonsillitis |
| • |
Ulcers of the palate or tonque. |
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Bleeding from inside the nose. (EPISTAXIS)
Bleeding inside the nose is a common complaint presenting as an
emergency and may occur in any age group. The various causes can
be
Local causes:
Finger nail trauma due to excessive nose picking; trauma to the
nose due to road accident or being hit by a ball or fist
Fracture of the nasal bones
Infections like viral rhinitis or acute sinusitis
Foreign bodies in nose
Deviation of the nasal septum
Atmospheric changes such as high altitudes
Any growth in the nasal cavity
General Causes
Hypertension – commonly seen in old age
Heart disease
Pregnancy
Bleeding disorders – when the patient has a deficiency in
the system responsible for control of bleeding and there is an abnormal
tendency to bleed
Drugs- Excessive use of analgesics for pain.
Acute general infections like Typhoid, Pneumonia, Malaria, Dengue
fever, Measles.
At times the cause of bleeding may not be clear.
Management
Most of the time, bleeding can be controlled by pinching the nose
tightly for about five minutes. Ice compress can be applied on the
nose. They aid in stopping the bleeding.
If bleeding is profuse, patient should be taken to the doctor.
Hypertensive patients should take their antihypertensive
medication regularly.
Excessive nose picking is a common cause of bleeding in
both children and young adults and should be discouraged.
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