earache
Introduction
Introduction Earache is a common disease. Ear pain is a common symptom. It is often caused by ear disease (primary or otogenic ear pain). It can also be caused by diseases of adjacent organs or other organs in the ear (secondary or Reflex earache). The severity of earaches may not be consistent with the severity of the lesion, but it may also be a sign of some serious disease (such as a malignant tumor of the ear). Obstruction of the Eustachian tube (the tube leading from the back of the throat to the middle ear) is the most common cause of earache in children and adults. Usually a cold, sinus infection or allergies can aggravate earache.
Cause
Cause
The ear has a rich distribution of sensory nerves. The main sensory nerve has a trigeminal nerve. The mandibular nerve ear branch is distributed on the tragus, part of the ear skin, the front wall of the external auditory canal, the upper wall and part of the tympanic membrane surface. The auricular nerve and the small nerve are all from the cervical plexus, distributed in the back of the ear, in front, on the surface of the bulge, and the large ear has branches to the external auditory canal. The ear of the vagus nerve, one distributed in the ear cavity, the posterior wall of the external auditory canal and the tympanic membrane, one in the posterior aspect of the auricle and adjacent to the mastoid skin. The tympanic nerve plexus is located on the middle ear tympanic surface. It consists of the swollen nerve tympanic branch, the tympanic nerve traffic branch of the facial nerve, and the internal carotid artery sympathetic plexus, which dominates the inner layer of the tympanic membrane and the tympanic membrane. Ear damage can be caused by the lesions of these nerves themselves or by the compression and stimulation of the outer or middle ear lesions or by the lesions of distant organs.
First, otogenic ear pain
1. Auricular diseases: auricular cartilage inflammation, auricular dermatitis and eczema, auricular erysipelas, congenital tube with infection, external ear tuberculosis. Auricular hematoma, malignant tumor.
2. External auditory canal diseases: external auditory canal, external auditory canal, malignant otitis externa, external ear canal fungal disease, external auditory canal embolization, external auditory canal cholesteatoma, external auditory canal trauma, ear canal obstructive keratosis.
3. Middle ear disease: bullous tympanitis, acute suppurative otitis media, acute suppurative otitis media, tympanic membrane trauma, barotrauma otitis media, acute mastoiditis, tuberculous otitis media, middle ear malignant tumor.
Second, reflex ear pain
1. Peripheral disorders: acute lymphadenitis around the ear, mumps.
2. Nasal disease: acute sinusitis, maxillary sinus cancer.
3. Oral and pharyngeal diseases: wisdom tooth pericoronitis, tongue root ulcer, acute tonsillitis, tonsillectomy, pharyngeal tumor, pharyngeal abscess, pharyngeal ulcer.
4. Laryngeal disease: laryngeal tuberculosis, hypopharyngeal carcinoma, and long styloid process.
Third, neurotic ear pain
1. Glossopharyngeal neuralgia.
2. Knee ganglion pain.
3. Throat nerve pain.
4. Cervical plexus pain.
Examine
an examination
Related inspection
Ear, nose, throat swab bacterial culture electrical sound impedance test
(1) medical history
For patients with earache, first ask about the nature of earache, such as jumping pain, pressure pain, acupuncture-like pain, knife-like pain, tearing pain, and pulling pain. The pain is light and heavy, and the duration is long and short. There are spontaneous pains, but also pain when chewing and swallowing. There is deep pain in the ear, and there is also radiation to the ipsilateral head and neck. Pay full attention to the characteristics of the accompanying symptoms so that appropriate examinations can be performed to confirm the diagnosis early.
(2) Inspection
During the examination, not only the changes in the ear and its surroundings, but also the nasal cavity, nasopharyngeal cavity, sinus, throat, mouth and head and neck should be noted.
Diagnosis
Differential diagnosis
It should be differentiated from the following symptoms:
Neurotic earache
Neurotic ear pain mainly includes viral neuritis, rheumatoid neuritis and the like, involving the geniculate ganglion, the semilunar ganglion, the second and third cervical nerves, the glossopharyngeal ganglia and the vagus nerve. The more common is herpes zoster caused by ganglion ganglion virus infection, and the affected nerves have severe pain in the walking parts. Secondly, it is often accompanied by earache when epiglottic nerve pain occurs.
2. Intermittent ear pain
It belongs to the liver and gallbladder and the wind is hot. The ear is dry and itchy. Expelling wind and heat. Add and subtract with cool sputum. Those who are flaming and flaming, have a lot of ear pain, and can see both red and hot swelling. Expelling heat and cooling blood, purging fire and detoxification. Add and subtract with Longdan Xiegan Decoction and Rhizoma Dihuang Decoction. It is a wind evil and dampness, pain and fester in the ear. Expelling hurricanes, dehumidification, and heat. Intermittent ear pain is uninterrupted ear pain, and the pain is not continuous but intermittent.
