Pain in the ear

Introduction Otitis media can cause pain in the ear. Otitis media is an inflammatory lesion involving all or part of the structure of the middle ear (including the eustachian tube tympanic cavity, sinus sinus and mastoid air chamber). Most of the inflammatory lesions are non-specifically arranged for inflammation, especially in children. Can be divided into two categories of non-suppurative and suppurative. Non-suppuratives include otitis media with otitis media with effusion in the otitis media. Suppurative patients have acute and chronic sputum, and specific inflammation is too rare, such as tuberculous otitis media. Commonly there are secretory otitis media, acute suppurative otitis media, cholesteatoma otitis media and air pressure 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. Some people often use two fingers to pinch the two sides of their nose when they blow their noses, and force the nose out. This method of blowing nose can not only completely remove the nose and is very dangerous. The nose contains a lot of viruses and bacteria. If the nostrils on both sides are pinched, the pressure will force the nose to squeeze out into the posterior nasal orifice and reach the Eustachian tube. Cause otitis media. Therefore, the correct method of blowing nose should be advocated: hold one side of the nostril with your finger, and use a little force to pull out the nose of the opposite nostril, and use the same method to rub the other side. If the nasal cavity is not easy to sputum, you can use the nasal spray nose of the chlorinated sputum, and then sputum after nasal ventilation.

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. Perforation of the tympanic membrane caused by trauma is not allowed to drip any water-like liquid, so as not to affect the healing of the wound. The external auditory canal can be blocked by a sterile cotton ball to prevent infection and induce 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. Therefore, the mother should take the seat when feeding the child, hold the baby in an oblique position, and suck the milk vertically.

5, in addition, smoking cigarettes can also cause otitis media. Smoking can cause systemic arteriosclerosis, especially when nicotine in cigarettes enters the bloodstream, causing small blood vessels to smash and increase viscosity, and the arterioles supplying blood to the inner ear are hardened, resulting in insufficient blood supply to the inner ear, which seriously affects hearing.

6, there are long-term use of headphones to listen to the music of the big decibels of the rock, if the time is long, it is easy to cause chronic otitis media, tissue damage to the ears, severe hearing loss and other complications, such as otitis media, etc. .

7, otitis media with numbness or blockage in the ear, hearing loss and tinnitus are the most common symptoms. Often occurs after a cold, or unconsciously. Sometimes head position changes can improve hearing. There is self-listening enhancement. Some patients have mild earache. Children often appear to be obedient or inattentive.

an examination

Related inspection

Hearing examination CT scan brain evoked potential

(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.

(5) Secretory otitis media can progress to adhesive otitis media or complicated tympanosclerosis.

Differential diagnosis

1. Pain behind the ear: Many patients often have pain in the mastoid part of the ear before the symptoms of facial paralysis.

2, external auditory canal pain: external ear canal pain is a kind of earache.

3, auricular pain: the ear is very rich in sensory nerves, and is also associated with the nerves of adjacent organs, so in addition to the symptoms of the ear itself, earache may also be reflective ear pain caused by diseases of adjacent organs.

4, intermittent ear pain: the most important cause of ear pain is inflammation, in addition, ear pain is also a common cause of ear pain. Neuropathic pain manifests as paroxysmal.

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