Pain at the base of the ear

Introduction Ear pain can be seen in otitis media, and oral tumors can also cause pain in the mouth and roots. Otitis media, also known as the "ear of the ear", initiates a disease, causing pain in the mind, and sometimes pus out of the ear. Although it is not a serious illness, it brings endless suffering. If the infant is breastfeeding in the supine position, because the eustachian tube of the child is relatively straight, and the lumen is short, the inner diameter is wide, the milk can be inserted into the middle ear through the eustachian tube to cause otitis media or the water will swallow in the mouth. Entering the middle ear through the nasopharynx causes otitis media.

Cause

1. Acute otitis media is an acute suppurative inflammation of the middle ear mucosa, which is most common in the eustachian tube. After the cold, the inflammation of the pharynx and nose spreads to the eustachian tube. The eustachian tube and the mucosa of the eustachian tube are congested and swollen, and the ciliary movement is impeded. The pathogenic bacteria invade the middle ear and cause otitis media. Common pathogens are mainly pneumococci, Haemophilus influenzae, etc., so preventing colds can reduce the chance of otitis media.

2. Incorrect snoring can also lead to otitis media.

3. Avoid swimming in the mouth when swimming, so as to prevent water from entering the middle ear through the nasopharynx and causing otitis media.

4. If the infant is breastfeeding in the supine position, because the eustachian tube of the child is relatively straight, and the lumen is short, the inner diameter is wide, and the milk can cause otitis media through the eustachian tube into the middle ear.

5, in addition, smoking cigarettes can also cause otitis media.

an examination

Related inspection

Otolaryngology CT examination ear examination

(1) Tympanic membrane: the slack or full tympanic membrane invagination, which is characterized by shortening, deforming or disappearing of the light cone, and the hammer stem is displaced backwards and upwards, and the short bones of the humerus are obviously protruding, and the angle between the front and rear folds becomes smaller. When the tympanic effusion is in the tympanic membrane, the tympanic membrane loses its normal luster. It is single yellow, orange-red oil or amber, and the cone is deformed or displaced. In chronic cases, it may be grayish blue or milky white. The tympanic membrane has dilated microvessels in the tension zone. The short protrusion is more smeared than the sacral color, and the humeral stem is embossed. If the liquid is serous and does not fill the tympanic cavity, the liquid level can be seen through the tympanic membrane. The liquid surface is like a curved hair, which is called a hairline, and the concave surface faces upward. When the head position changes, the relationship parallel to the ground does not change. Bubbles are visible through the tympanic membrane, and the air bubbles can be increased after the eustachian tube is blown. The tympanic membrane of the tympanic membrane is limited.

(2) The sound of the bottle stopper: the pressure is released after the tragus is pressed, and the ears are tested separately. The patient consciously has an ear sound similar to that of the bottle stopper.

(3) Hearing examination: The results of the tuning fork test and the pure music listening valve test show that the conductivity is paralyzed. Hearing loss is different, and the weight can be as high as 40dB HL. Since the amount of effusion often changes, the hearing threshold may fluctuate. Hearing loss is generally low frequency, but due to the structure of the middle ear ship and the impedance changes of the two springs, the high frequency air conduction and bone conduction hearing can also be objectively reduced, and the hearing is improved after the effusion is discharged. The acoustic guide chart has important value for diagnosis. The flat type (type B) is a typical curve of secretory otitis media; the high negative force type (type C3) shows that the pharyngeal tube is dysfunctional, and some have tympanic effusion. If the hearing impairment is significant, auditory brainstem response and otoacoustic emission examination should be performed to determine whether it affects the inner ear.

(4) CT scan showed that the air cavity of the middle ear system had different degrees of density increase.

Differential diagnosis

Secretory otitis media should be differentiated from acute otitis media. The diagnosis of secretory otitis media was confirmed using a tympanogram. Clinically, the side and duration of secretory otitis media should be monitored for the presence of combined symptoms and severity. According to clinical symptoms and pink or yellow oily tympanic membrane, hairline, and type B tympanogram, general diagnosis is not difficult. Diagnostic tympanostomy can be diagnosed under aseptic conditions if necessary.

1. Hearing loss: hearing loss and self-listening. When the head is leaning forward or leaning to the healthy side, the hearing can be temporarily improved (displacement hearing improvement) due to the effusion leaving the snail. When the effusion is thick, the hearing may not change due to head position changes. Children often have a slow response to the voice, lack of concentration, and the academic performance is reduced and the parents receive medical treatment. If one ear is sick, the other ear hearing is normal, and it can be undetected for a long time, but it is found at the time of physical examination.

2, earache: acute people may have faint earache, often the first symptom of the patient, which may be persistent or painful. Chronic ear pain is not obvious. This disease is often accompanied by occlusion or swell in the ear, which can be temporarily relieved after pressing the tragus.

3, tinnitus: mostly low-key intermittent, such as "" sound, snoring and running water sound. When the head is moving or yawning or blowing your nose, there may be a sound of gas over the ear.

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