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pain in the eye resulting from exposure to bright light (often associated with albinism) (同)photophobia

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/07/07 17:27:21」(JST)

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Otalgia or an earache or ear pain is pain in the ear. Primary otalgia is ear pain that originates inside the ear. Referred otalgia is ear pain that originates from outside the ear.

Otalgia is not always associated with ear disease. It may be caused by several other conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections in the nose and pharynx, throat cancer, and occasionally as a sensory aura that precedes a migraine.

Primary otalgia

Ear pain can be caused by disease in the external, middle, or inner ear, but the three are indistinguishable in terms of the pain experienced.

External ear pain may be:

Mechanical: trauma, foreign bodies such as hairs, insects or cotton buds.
Infective (otitis externa): Staphylococcus, Pseudomonas, Candida, herpes zoster, or viral Myringitis. (See Otitis externa)

Middle ear pain may be:

Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media.
Inflammatory / infective: acute otitis media, mastoiditis.

Referred pain

The neuroanatomic basis of referred otalgia rests within one of five general neural pathways.^[1] The general ear region has a sensory innervation provided by four cranial nerves and two spinal segments. Hence, pathology in other "non-ear" parts of the body innervated by these neural pathways may refer pain to the ear. These general pathways are:

Via Trigeminal nerve [cranial nerve V]. Rarely, trigeminal neuralgia can cause otalgia. Oral cavity carcinoma can also cause referred ear pain via this pathway.
Via Facial nerve [cranial nerve VII]. This can come from the teeth, the temporomandibular joint (due to its close relation to the ear canal), or the parotid gland.
Via Glossopharyngeal nerve [cranial nerve IX]. This comes from the oropharynx, and can be due to pharyngitis, pharyngeal ulceration, tonsillitis, or to carcinoma of the oropharynx (base of tongue, soft palate, pharyngeal wall, tonsils).
Via Vagus nerve [cranial nerve X]. This can arise from the laryngopharynx in carcinoma of this area, or from the esophagus in GERD.
Via the second and third spinal segments, C2 and C3.

In an adult with chronic ear pain, yet a normal ear on exam, the diagnosis is carcinoma of the head and neck region until proven otherwise. Yet some patients will have a "psychogenic otalgia," and no cause as to the pain in ears can be found (suggesting a psychosomatic origin). The patient in such cases should be kept under observation with periodic re-evaluation.

Dental disease may cause pain in the region of the ear. E.g. dental caries causing pulpitis and/or periapical periodontitis (which may be associated with a periapical abscess) in a tooth can be referred via the auriculotemporal nerve (a branch of the trigeminal nerve), the tympanic nerve (a branch of the glossopharyngeal nerve) or via the auricular nerve (a branch of the vegas nerve). Temporomandibular joint dysfunction, impacted third molar teeth, and lesions of the floor of mouth or ventral surface of the tongue (underside of the tongue) are other possible causes of dental conditions which can cause ear pain.^[2]

Cause

It is not unusual for an ear infection to develop in early childhood. Ear infections can occur as side effects of contagious illnesses—colds, coughs, or eye ailments like conjunctivitis.^[3]

Diagnosis

It is normally possible to establish the cause of ear pain based on the history. It is important to exclude cancer where appropriate, particularly with unilateral otalgia in an adult who uses tobacco or alcohol.^[4] Often migraines are caused by middle ear infections which can easily be treated with antibiotics. Often using a hot washcloth can temporarily relieve ear pain.

Management

With proper antibiotic ear medication in 90% of cases the infection goes away in seven or eight days.^[5] ,

References

^ Scarbrough TJ; Day, TA; Williams, TE; Hardin, JH; Aguero, EG; Thomas Jr, CR (2003). "Referred otalgia in head and neck cancer: a unifying schema". American Journal of Clinical Oncology 26 (5): e157–62. doi:10.1097/01.coc.0000091357.08692.86. PMID 14528091.
^ Quail, G; Mueller, D; Yoon, MS; Pageler, L; Diener, H; Katsarava, Z (August 2005). "Atypical facial pain--a diagnostic challenge.". Australian family physician 34 (8): 641–5. PMID 16113700. Cite uses deprecated parameters (help)
^ Institute for Good Medicine at the Pennsylvania Medical Society,http://www.myfamilywellness.org/MainMenuCategories/FamilyHealthCenter/AntibioticResistance/Earaches.aspx, 2009.
^ Amundson L (1990). "Disorders of the external ear". Prim Care 17 (2): 213–31. PMID 2196606.
^ Thompson, M; Vodicka, TA; Blair, PS; Buckley, DI; Heneghan, C; Hay, AD; TARGET Programme, Team (Dec 11, 2013). "Duration of symptoms of respiratory tract infections in children: systematic review.". BMJ (Clinical research ed.) 347: f7027. doi:10.1136/bmj.f7027. PMID 24335668. Cite uses deprecated parameters (help)

External links

What to do if your child has earache from Seattle Children's Hospital

UpToDate Contents

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1. 小児における耳痛の評価 evaluation of earache in children
2. 成人における急性中耳炎（化膿性および漿液性） acute otitis media in adults suppurative and serous
3. 外耳炎：治療 external otitis treatment
4. 耳管機能障害 eustachian tube dysfunction
5. 中間神経神経痛 nervus intermedius neuralgia

English Journal

Screening preschool children with toothache: validation of the Brazilian version of the dental discomfort questionnaire.

Daher A, Versloot J, Leles CR, Costa LR.AbstractBACKGROUND: The Dental Discomfort Questionnaire (DDQ) is an observational instrument intended to measure dental discomfort and/or pain in children under 5 years of age. This study aimed to validate a previously cross-culturally adapted version of DDQ in a Brazilian children sample.
Health and quality of life outcomes.Health Qual Life Outcomes.2014 Mar 4;12(1):30. [Epub ahead of print]
BACKGROUND: The Dental Discomfort Questionnaire (DDQ) is an observational instrument intended to measure dental discomfort and/or pain in children under 5 years of age. This study aimed to validate a previously cross-culturally adapted version of DDQ in a Brazilian children sample.METHODS: Participa
PMID 24593691

When the simple migrated hair results in distressing ear symptoms.

Hoe YM1, Lee TS2, Tan B3, Loh IC2.Author information 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: yingminhoe@gmail.com.2Department of Otolaryngology, Changi General Hospital, Singapore.3Singhealth, Singapore.AbstractWe present 3 patients who complained of distorted hearing, tinnitus and otalgia resulting from scalp and facial hair impacting against the tympanic membrane. Removal of the migrated hair with microsuction relieved symptoms immediately. In 2 cases, the patients had presented to the primary care physician earlier, shortly after a haircut. The family physicians had correctly detected the migrated hair but failed to identify this as the cause of the patient's symptoms. Increased awareness of this potentially common complication will enable the family physician to identify and treat these patients in a primary care setting.
American journal of otolaryngology.Am J Otolaryngol.2014 Mar-Apr;35(2):274-5. doi: 10.1016/j.amjoto.2013.09.005. Epub 2013 Sep 28.
We present 3 patients who complained of distorted hearing, tinnitus and otalgia resulting from scalp and facial hair impacting against the tympanic membrane. Removal of the migrated hair with microsuction relieved symptoms immediately. In 2 cases, the patients had presented to the primary care physi
PMID 24315630

Acoustic shock controversies.

Hooper RE.Author information Private practice, Melbourne, Victoria, Australia.AbstractBackground: The diagnosis 'acoustic shock' has been made increasingly in the health care industry in recent years. This paper aims to question the validity of acoustic shock as an organic pathological entity. Methods: The experiences of 16 individuals diagnosed as having acoustic shock, within a medico-legal practice, are reviewed. Results: The commonest symptom was otalgia, followed by noise sensitivity, tinnitus, hearing disturbance and dizziness. Conclusion: The presence of noise-limiting technology in the workplace, the variation in the nature of the acoustic incident involved (ranging from a shriek, through feedback noise, to a male voice), and the marked variation in the time of symptom onset (following the acoustic incident) all suggest that the condition termed acoustic shock is predominantly psychogenic. Cases of pseudohypacusis indicate that malingering is a factor in some cases. Clusters of acoustic shock events occurring in the same call centres suggest that hysteria may play a part. The condition is usually only seen when work-related issues are apparent.
The Journal of laryngology and otology.J Laryngol Otol.2014 Feb 25:1-8. [Epub ahead of print]
Background: The diagnosis 'acoustic shock' has been made increasingly in the health care industry in recent years. This paper aims to question the validity of acoustic shock as an organic pathological entity. Methods: The experiences of 16 individuals diagnosed as having acoustic shock, within a med
PMID 24565111

Japanese Journal

A Case of Perilymph Fistula Following Eustachian Tube Insufflation

耳鼻咽喉科臨床　補冊 144(0), 4-5, 2015
NAID 130005110241

A Case of Epithelial-myoepithelial Carcinoma of Parotid Gland that Caused Multiple Cranial Nerve Disorders

耳鼻咽喉科臨床　補冊 144(0), 100-100, 2015
NAID 130005110215

多発脳神経障害をきたした耳下腺上皮筋上皮癌例

耳鼻咽喉科臨床 108(4), 301-305, 2015
NAID 130005061542

Related Pictures

★リンクテーブル★

リンク元

「耳痛」「耳痛症」

「耳痛」

Otalgia
ICD-10	H60 Otitis Externa H65&H66 Otitis Media H92 Otalgia
ICD-9	380.1 Otitis Externa 381 Otitis Media 388.7 Otalgia
DiseasesDB	18027
MedlinePlus	003046
eMedicine	ent/199

　　[★]

英: otalgia, ear pain, otodynia, earache
関: 耳痛症

分類

耳性耳痛：耳介、外耳道、中耳：三叉神経、舌咽神経、迷走神経、頚神経：外耳炎、耳介軟骨膜炎、外耳道異物、急性中耳炎
非耳性耳痛(放散痛、放散性耳痛)

耳介側頭神経：歯疾患、唾液腺疾患、副鼻腔疾患
舌咽神経：中咽頭などからの放散痛
迷走神経：下咽頭、喉頭からの放散痛
大耳介神経：
小後頭神経

「耳痛症」

　　[★]

英: otalgia
関: 耳痛

[otalgia1-1] Scarbrough TJ; Day, TA; Williams, TE; Hardin, JH; Aguero, EG; Thomas Jr, CR (2003). "Referred otalgia in head and neck cancer: a unifying schema". American Journal of Clinical Oncology 26 (5): e157–62. doi:10.1097/01.coc.0000091357.08692.86. PMID 14528091.

[Quail_2005-2] Quail, G; Mueller, D; Yoon, MS; Pageler, L; Diener, H; Katsarava, Z (August 2005). "Atypical facial pain--a diagnostic challenge.". Australian family physician 34 (8): 641–5. PMID 16113700. Cite uses deprecated parameters (help)

[3] Institute for Good Medicine at the Pennsylvania Medical Society,http://www.myfamilywellness.org/MainMenuCategories/FamilyHealthCenter/AntibioticResistance/Earaches.aspx, 2009.

[otalgia2-4] Amundson L (1990). "Disorders of the external ear". Prim Care 17 (2): 213–31. PMID 2196606.

[5] Thompson, M; Vodicka, TA; Blair, PS; Buckley, DI; Heneghan, C; Hay, AD; TARGET Programme, Team (Dec 11, 2013). "Duration of symptoms of respiratory tract infections in children: systematic review.". BMJ (Clinical research ed.) 347: f7027. doi:10.1136/bmj.f7027. PMID 24335668. Cite uses deprecated parameters (help)

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案内

otalgia