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PubMed1985

Characteristics of earache among children with acute otitis media.

The frequency and correlates of earache were studied prospectively among 335 consecutive episodes of acute otitis media with effusion (AOME) diagnosed in a suburban pediatric practice. Earache was severe in 142 (42%) episodes, mild/moderate in 135 (40%), and absent in 58 (17%). The incidence of apparently painless AOME was higher among children less than 2 years old than among older children (25% v 7%). Redness of the completely bulging tympanic membrane was associated with an increased likelihood of earache. Neither gender nor the extent of involvement (one v both ears) was independently related to earache. Earache is not an invariable component of AOME, especially among infants and young children. Detection of all cases of AOME among young children requires a high index of suspicion, even in the apparent absence of earache.

Age Factors↗

PubMed2000

One hundred earaches. Family practice case series.

OBJECTIVE: To examine whether watchful waiting was an appropriate strategy for patients with earache, when there was no clear indication to prescribe antibiotics at the first visit. DESIGN: Case series of consecutive patients with unilateral earache. SETTING: Rural family practice clinic and walk-in centre. PARTICIPANTS: One hundred patients with unilateral earache. INTERVENTIONS: Patients who clearly needed antibiotic treatment were given it; others were advised about symptom relief and were followed up as necessary. MAIN OUTCOME MEASURES: Whether patients returned to the clinic, and whether antibiotics were subsequently prescribed. RESULTS: Two patients were prescribed antibiotics at the first visit. Of the remaining 98 people, only four returned to the clinic because of earache, and two of these were prescribed antibiotics. Thus, of 100 people with earache, four received antibiotic prescriptions. CONCLUSIONS: Most people who present to primary care physicians with earache do not need antibiotics for what appears to be a mostly self-limiting condition. Both physicians and patients should be educated about this.

Adolescent↗

PubMed2003

Secondhand smoke and earaches in adolescents: the Florida Youth Cohort Study.

The association between second-hand smoke exposure and adolescent middle ear problems has not been examined. A random sample stratified by region was drawn from a list that included approximately 40% of all Florida households with children in grades 4-7. A total of 785 Florida adolescents initially enrolled in the 4th-7th grade participated in three telephone interviews conducted over a 24-month period. At the round 3 interview, 10.3% of participants reported one or more earaches within the previous 30 days. Several second-hand smoke exposure questions asked at each of the three interviews were associated with the number of reported earaches. Stepwise polytomous logistic regression indicated that parental smoking inside the home reported at the round 3 interview was associated with the number of reported earaches (OR=3.11, 95% CI=1.70-5.66). Once this variable was selected, none of the other second-hand smoke exposure variables offered additional predictive value (p>.1). None of the non-second-hand smoke exposure variables, including the participant's own history of tobacco use, had any association with the reporting of earaches (p>.05). Second-hand smoke exposure is associated with self-reported earaches in adolescents. These findings should be replicated in a study in which clinical measures of middle ear function are performed.

Adolescent↗

PubMed1990

Treatment of earache among the Lappish people.

The traditional ways of treating earache among the Lappish people have been charted. Generally speaking, the Lapps have treated earache by applying a compress to the ear, dropping various ear-drops into the external auditory canal, breathing into the ear, massaging the ear, and inserting impregnated wool into the ear canal. The Lappish treatment principles for earache are discussed in relation to modern knowledge of pain relief.

Earache↗

PubMed1978

Earache and glue ear.

In most cases, the cause of an earache is obvious. If the cause is not apparent after careful inspection, a systematic approach to the associated causes and sites of referred pain is necessary. Glue ear is the most frequent cause of hearing loss in children. The diagnosis, investigation and management have been described. Recurrent earache from pressure change or from recurrent middle ear infection is an important clue to the presence of a glue ear.

Child↗

PubMed1980

Psychogenic earache: An unusual cause of otalgia.

A 19-year-old female patient presented with a nine-month history of severe persistent earache for which no organic cause could be found. It later proved to be psychogenic in origin and was completely relieved when its psychological significance was understood and accepted by the patient. This is an unusual cause of earache. Its diagnosis and management are discussed.

Adult↗

PubMed1999

Evaluation of the patient with sore throat, earache, and sinusitis: an evidence based approach.

Sore throat, earache, and sinusitis are common presenting complaints in the emergency department, and all fall within the top ten in the United States. These complaints usually have a benign course but rarely can be a symptom of a serious disease process. This article provides an evidence-based review of the literature regarding the diagnosis of pharyngitis, otitis media, and sinusitis.

Adult↗

PubMed1998

[Referred earache; an important symptom of head-and-neck cancers].

Otalgia is a common symptom in general practice and represents the sensation of pain in the ear. In four patients, three women aged 63, 57 and 37 years, and a man aged 64 years, ear pain was found to be caused by laryngeal carcinoma (two patients), oropharyngeal carcinoma and nasopharyngeal carcinoma (in a Turkish patient). Referred otalgia is an earache that is caused by a nonotologic source. In many cases it is difficult to identify the underlaying disease of referred otalgia. It may be the first symptom of a head-and-neck carcinoma. In case of otalgia with normal otologic findings, the differential diagnostic process must be specifically directed to the common sensory innervation of the ear and the head-and-neck structures. By carefully taking the patient's history with special attention to epidemiological factors such as smoking and drinking habits, racial traits, a positive family history of head-and-neck neoplasms and accompanying complaints and by performing repeated ENT examination including advanced imaging techniques, long delay in diagnosing head-and-neck cancer can be prevented.

Adult↗

PubMed1985

The phantom earache. Temporomandibular joint dysfunction in children.

Temporomandibular joint dysfunction is a benign, relatively uncommon childhood disorder and should be considered in children who have intermittent unilateral otalgia of three to four days' duration and whose audiographic, tympanometric, and clinical otologic examinations reveal normal findings. Most of the patients in our study had undergone orthodontic therapy during the year preceding the onset of temporomandibular joint dysfunction, and the vast majority of them had received orthodontic treatment within two weeks of each episode of otalgia. The diagnosis can be confirmed clinically by reproducing the pain associated with masticatory muscle spasm by palpation of the preauricular areas, intraotic manipulation, and palpation of the pterygoid muscles. Treatment consists of administering acetaminophen, applying hot compresses to the preauricular area, and opening and closing the mouth 30 to 40 times after each compress as an effort to interrupt the muscle spasm.

Adolescent↗

PubMed1996

Supertasting, earaches and head injury: genetics and pathology alter our taste worlds.

Family studies using thresholds showed that PROP (6-n-propylthiouracil) tasting is produced by a dominant allele, T. Nontasters have two recessive alleles and tasters have one or two dominant alleles. The bitterness of suprathreshold PROP and anatomical criteria subdivide tasters into medium and supertasters. Supertasters may be TT tasters, but this has yet to be demonstrated. Supertasters preceive the greatest bitterness and sweetness from many stimuli as well as the greatest oral burn from alcohol and capsaicin. Women are more likely than men to be supertasters. Otitis media and head trauma can alter taste and thus PROP classifications, complicating studies on PROP genetics. Some subjects with a history of otitis media show taste reductions, but others show enhanced tastes and appear to have more taste buds per fungiform papilla. Subjects with head trauma show reduced tastes on some oral loci, but there is evidence that severe reductions on the front of the tongue ameliorate reductions at the circumvallate papillae on the back of the tongue by a release of inhibition mechanism.

Brain Injuries↗

PubMed1984