Materiały źródłowe

• #1 Diagnosis of Ear Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p621.html

  Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary otalgia is usually apparent on examination; the most common causes are otitis media and otitis externa. The cause of secondary otalgia is often difficult to determine because the innervation of the ear is complex and there are many potential sources of referred pain. The most common causes are temporomandibular joint syndrome, pharyngitis, dental disease, and cervical spine arthritis. If the diagnosis is not clear from the history and physical examination, options include a trial of symptomatic treatment without a clear diagnosis; imaging studies; and consultation with an otolaryngologist. Patients who smoke, drink alcohol, are older than 50 years, or have diabetes are at higher risk of a cause of ear pain that needs further evaluation. Patients whose history or physical examination increases suspicion for a serious occult cause of ear pain or whose symptoms persist after symptomatic treatment should be considered for further evaluation, such as magnetic resonance imaging, fiberoptic nasolaryngoscopy, or an erythrocyte sedimentation rate measurement.

• #2 Ear Pain: Diagnosing Common and Uncommon Causes | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0101/p20.html

  Otalgia (ear pain) is a common presentation in the primary care setting with many diverse causes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. […] Pain that originates outside the ear is called secondary otalgia, and the etiology can be difficult to establish because of the complex innervation of the ear. The most common causes of secondary otalgia include temporomandibular joint syndrome and dental infections. […] History and physical examination usually lead to the underlying cause; however, if the diagnosis is not immediately clear, a trial of symptomatic treatment, imaging studies, and consultation may be reasonable options. […] When risk factors for malignancy are present (e.g., smoking, alcohol use, diabetes mellitus, age 50 years or older), computed tomography, magnetic resonance imaging, or otolaryngology consultation may be warranted.

• #3 Otalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549830/

  Otalgia or ear pain is a multifaceted condition categorized into primary and secondary otalgia. Primary otalgia originates directly from an ear pathology, while secondary otalgia results from referred pain from extraneous sources. The differential diagnoses and evaluation strategies are extensive due to the intricate neural network responsible for ear sensations. Understanding the relevant neural connections is pivotal for diagnostic accuracy and management effectiveness. […] The first step in evaluating otalgia is a comprehensive clinical evaluation, encompassing a thorough history and physical examination. The ear examination is often enough to conclude whether otalgia is primary or secondary. However, a primary ear pathology should still be further evaluated to arrive at the correct diagnosis.

• #4 Otalgia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/845173-overview

  Otalgia is defined as ear pain. Two separate and distinct types of otalgia exist. Pain that originates within the ear is primary otalgia; pain that originates outside the ear is referred otalgia. Typical sources of primary otalgia are external otitis, otitis media, mastoiditis, and auricular infections. Most physicians are well trained in the diagnosis of these conditions. When an ear is draining and accompanied by tympanic membrane perforation, simply looking in the ear and noting the pathology can make the diagnosis. When the tympanic membrane appears normal, however, the diagnosis becomes more difficult. […] Referred otalgia is a topic unto itself. Although many entities can cause referred otalgia, their relationship to ear pain must be identified. A categorical discussion of the workup, treatment, prognosis, demographics, and other issues is impossible because the various pathologies responsible for creating referred otalgia are so diverse.

• #5 Ear Pain: Diagnosing Common and Uncommon Causes | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0101/p20.html

  A comprehensive history and physical examination are essential to determine the etiology of primary or secondary otalgia. […] The etiology of primary otalgia, which is usually identified on examination of the ear, is typically otitis externa or otitis media. […] The diagnosis of acute otitis media requires moderate to severe bulging of the tympanic membrane, new onset of otorrhea not caused by otitis externa, or mild bulging of the tympanic membrane associated with recent onset of ear pain (less than 48 hours) or erythema. […] Magnetic resonance imaging and referral for nasolaryngoscopy are recommended in the setting of otalgia with normal ear examination findings and symptoms of or risk factors for tumor. […] Patients 50 years and older with otalgia and a normal ear examination should be evaluated for temporal arteritis.

• #6 How to diagnose and manage primary and secondary earache and ear infections – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/how-to-diagnose-and-manage-primary-and-secondary-earache-and-ear-infections

  Earache is a common problem that can be the result of a variety of different pathologies. It is important for pharmacists and healthcare professionals to appropriately diagnose primary and secondary earache and ear infections. […] If a patient presents with earache, a detailed history and thorough examination (e.g. otoscopic examination) should help determine the underlying cause, and direct treatment choice. […] If a patient presents with earache, a detailed history and thorough examination should help determine the underlying cause. Examination of the tympanic membrane (TM) is important in differential diagnosis and ideally would be checked to see if it is intact and mobile with pneumatic insufflation. […] This article discusses how to diagnose and treat earache and ear infections.

• #7 Ear infection (middle ear) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ear-infections/diagnosis-treatment/drc-20351622

  A healthcare professional can often diagnose an ear infection based on symptoms and an exam. The exam likely includes looking inside the child’s ears with a lighted instrument known as an otoscope. If the eardrum is red and bulging, there’s likely an infection. […] Other tests might be needed if there’s doubt about a diagnosis, if the condition hasn’t gotten better with treatment or if there are other issues. […] The diagnosis of ear infection often means acute otitis media. This involves having fluid in the middle ear or symptoms of an infection, such as fluid suddenly coming from the ear. […] This means there’s fluid in the middle ear, but no symptoms of infection. […] This is caused by a long-term ear infection that caused a tear in the eardrum. This condition often involves pus coming from the ear.

• #8 Diagnosing ear pain | Harley Street ENT Clinic

  https://www.harleystreetent.com/blog/diagnosing-ear-pain

  Ear pain is something that many of us may have experienced as children. It can present in adults too with a number of different causes. […] Thats why its so important to get the right diagnosis for ear pain and to do this as soon as possible. The first step in diagnosing ear pain is to find out how the patient got to this point. […] The type of pain may have an influence on the eventual diagnosis for example, continuous pain that gets progressively worse could be a sign of an infection. […] The second stage in diagnosing ear pain is for the specialist to physically examine the patient. […] An ENT specialist will also examine other areas around the source of pain. […] In the process of diagnosis it will be necessary to eliminate a range of causes, from infection through to the after effects of traumatic injury in order to identify what the true cause of the problem really is.

• #9 Ear Ache Diagnosis And Treatment | Urgent Care Clinic of Lincoln

  https://ucclincoln.com/services/ear-ache-diagnosis-and-treatment/

  Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also likely listen to your child breathe with a stethoscope. […] An instrument called a pneumatic otoscope is often the only specialized tool a doctor needs to make a diagnosis of an ear infection. This instrument enables the doctor to look in the ear and judge whether there is fluid behind the eardrum. With the pneumatic otoscope, the doctor gently puffs air against the eardrum. Normally, this puff of air would cause the eardrum to move. If the middle ear is filled with fluid, your doctor will observe little to no movement of the eardrum. […] Your doctor may perform other diagnostic tests if there is any doubt about a diagnosis, if the condition hasn’t responded to previous treatments, or if there are other persistent or serious problems.

• #9 Ear Ache Diagnosis And Treatment | Urgent Care Clinic of Lincoln

  https://ucclincoln.com/services/ear-ache-diagnosis-and-treatment/

  The diagnosis of ear infection is generally shorthand for acute otitis media. Your doctor likely makes this diagnosis if he or she observes signs of fluid in the middle ear, if there are signs or symptoms of an infection, and if the onset of symptoms was relatively sudden. […] If the diagnosis is otitis media with effusion, the doctor has found evidence of fluid in the middle ear, but there are presently no signs or symptoms of infection. […] If the doctor makes a diagnosis of chronic suppurative otitis media, he or she has found that a persistent ear infection resulted in tearing or perforation of the eardrum.

• #10 Ear Infection (Otitis Media): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/8613-ear-infection-otitis-media

  Ear infections (acute otitis media) occur when a virus or bacteria infects the space behind your child’s eardrum. Symptoms include ear pain that may cause your infant or toddler to be especially fussy or irritable. […] An ear infection, also called acute otitis media, is a sudden infection in your middle ear. […] Most healthcare providers can tell if your child has an ear infection based on their symptoms, a physical exam to check for signs of a cold and an ear exam. […] An inflamed, swollen or red eardrum is a sign of an ear infection. […] Your child may need other tests, including tympanometry, acoustic reflectometry, tympanocentesis, and hearing tests to determine if your child has hearing loss. […] Treatment depends on many factors, including your child’s age, the severity of the infection, the nature of the infection (first-time, ongoing or repeat infection), and whether fluid remains in the middle ear for a long time.

• #11 Ear Infection (Otitis): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/ear-infections/treatment

  How is an Ear Infection Diagnosed? Diagnosis Most ear infections can be diagnosed in your doctor’s office. The doctor will ask about symptoms and perform an exam using a pneumatic otoscope tool during an ear infection diagnosis. The doctor can see inside the ear with the otoscope and gently puff air against the eardrum. A normal eardrum will move when the air is applied, but there will be little to no movement if fluid and infection are present. There may also be redness in the area. […] If you have persistent ear infections or complications, your doctor may use these tests to determine if your symptoms may be caused by something else: Tympanometry to examine movement of the eardrum and assess pressure in the middle ear, Acoustic reflectometry to measure fluids in the middle ear, Tympanocentesis to pierce the eardrum using a tiny tube and gather a sample of fluid to analyze for bacteria or viruses if the ear infection has not been responding to treatment, Audiology (hearing test).

• #12 How Middle Ear Infections Are Diagnosed

  https://www.verywellhealth.com/how-ear-infections-are-diagnosed-4160995

  Healthcare providers can safely examine ears for infection using an otoscope. This special tool has a light and a lens that help them see all the way to the eardrum without the risk of puncturing it. Usually, this exam is enough to make a diagnosis. […] Your healthcare provider will check to see if the eardrum appears cloudy, red, yellow, or swollen. Signs of fluid behind the eardrum or in the ear canal will confirm the diagnosis. […] A buildup of fluid in the middle ear and drainage of pus is consistent with an ear infection. […] In most cases, imaging is not necessary to check for an ear infection. However, your healthcare provider may order imaging tests if the ear infection persists despite treatment or if there’s a concern about complications or about a possible cholesteatoma. […] If it lasts longer, it should be checked out by a healthcare provider, who will use an otoscope to examine the ear.

• #13 Diagnosis of Ear Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p621.html

  Ear pain (otalgia) is a common symptom in primary care with many possible causes. When the cause arises from the ear (primary otalgia), the ear examination is usually abnormal and the diagnosis is typically apparent. In secondary or referred otalgia, the ear examination is usually normal, and the pain may be referred from a variety of sites. […] An assessment of hearing, by audiometry or simple testing (i.e., finger rub or whispered voice), is indicated in patients who notice hearing loss. An assessment of tympanic membrane mobility with pneumatic otoscopy or tympanometry can be helpful if there is suspicion of middle ear disease. When the physical examination is normal and the goal is to rule out tumor, the patient should have nasolaryngoscopy and magnetic resonance imaging (MRI) of the head and neck with gadolinium contrast.

• #14 Otitis Media Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/otitis-media/diagnosis.html

  A doctor will diagnose a middle ear infections by doing a physical exam and an ear exam and by asking questions about past health. […] The doctor uses a tool called a pneumatic otoscope to look at the eardrum for signs of an ear infection or fluid buildup. […] Other tests may include: […] Hearing tests. These tests are recommended for children who have had fluid in one or both ears (otitis media with effusion) for a total of 3 months. […] Tympanometry. It measures how the eardrum responds to a change of air pressure inside the ear. […] Tympanocentesis. This test can remove fluid if it has stayed behind the eardrum (chronic otitis media with effusion) or if infection continues even with antibiotics. […] Blood tests. These are done if there are signs of immune problems.

• #15 Earache – Symptoms, Types, Causes & Diagnosis

  https://www.ganeshdiagnostic.com/blog/earache-symptoms-types-causes-and-diagnosis

  Tympanometry: The medical professional applies a tool to seal off and regulate the pressure inside the ear canal. The instrument gauges eardrum movement. This allows the physician to determine the pressure in the middle ear. […] Sound reflection measurement: By bouncing sound against the eardrum, this technique operates. The volume of sound that is reflected back reveals the amount of fluid buildup. The bulk of sound will be absorbed by a healthy ear, however, an infected ear will reflect more sound waves. […] Tympanocentesis: Tympanocentesis may be used by a clinician if an ear infection has not responded favorably to other treatments. During this surgery, a tiny hole is made in the eardrum, and some inner ear fluid is drained. The source of the infection can then be identified by testing this fluid.

• #16 Ear infections: Symptoms, types, and causes

  https://www.medicalnewstoday.com/articles/167409

  Ear infections are the most common reason that children visit doctors. […] An ear infection is a bacterial or viral infection of the middle ear. This infection causes inflammation and the buildup of fluid behind the eardrum. […] Testing for ear infection is a relatively simple procedure and a diagnosis can often be made based on symptoms and a physical exam. […] The doctor will generally use an otoscope, an instrument with a light attachment, to check for fluid behind the eardrum. […] If in doubt, the doctor may use other methods to confirm a middle ear infection. […] Both acoustic reflectometry and tympanometry can help show fluid in the middle ear. However, they do not show whether the fluid is infected. […] If an ear infection has not responded well to treatment, a doctor may use tympanocentesis. This procedure involves creating a small hole in the eardrum and draining a small amount of fluid from the inner ear. This fluid can then be tested to determine the cause of the infection. […] In some cases, ear infections will clear on their own without antibiotics. However, ear infections that are severe and last longer than 2 to 3 days require antibiotics. […] If the diagnosis is COME, then a healthcare professional may recommend ear tubes as a part of treatment.

• #17 Ear Infection: Symptoms, Causes, Treatment, and More

  https://www.healthline.com/health/ear-infections

  If your symptoms get worse or don’t improve, see a doctor. […] A healthcare professional will consider your symptoms and examine your ears with an instrument called an otoscope that has a light and magnifying lens. […] This exam is rarely painful, but some children may be bothered. […] Other tests include: Fluid sample. If your infection is advanced, your doctor may take a sample of the fluid inside your ear and test it to determine whether certain types of antibiotic-resistant bacteria are present. […] The following practices may reduce the risk of ear infection: washing your hands often, avoiding overly crowded areas, forgoing pacifiers with infants and small children, breastfeeding infants, avoiding secondhand smoke, keeping immunizations up to date. […] Ear infections are caused by bacteria or viruses in your middle ear, which is the part of your ear behind your eardrum.

• #18 Ear Pain: Diagnosing Common and Uncommon Causes | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0101/p20.html

  The diagnosis of primary otalgia rarely requires more than a history and physical examination. […] Likewise, most cases of secondary otalgia can be diagnosed with a history and physical examination. […] When the physical examination is unremarkable (especially if there are concerning historical features), nasolaryngoscopy, tympanometry, audiometry, and laboratory evaluation with a complete blood count and erythrocyte sedimentation rate can be helpful. […] Advanced imaging for evaluation of otalgia may be most efficiently ordered in consultation with an otolaryngologist.

• #19 Diagnosis of Ear Pain | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p621.html

  Referring to a list of the causes of otalgia may be helpful, but in many patients these causes do not seem to fit. When the evaluation is unrevealing, a diagnosis of possible TMJ syndrome or eustachian tube dysfunction is often made. The physician must then decide whether to treat the patient symptomatically or to evaluate further with MRI or fiberoptic nasolaryngoscopy. […] As with any symptom, a rule out worst-case scenario strategy (in which certain diagnoses must be ruled out immediately) may help avoid serious diagnostic errors. In patients with otalgia, physicians should rule out several potential causes that can have serious consequences if the diagnosis is delayed; these are malignant (necrotizing) otitis externa, cholesteatoma, myocardial infarction, temporal arteritis, and malignant tumor. However, these diseases can often be ruled out on the basis of a nonworrisome history and physical examination rather than extensive testing. Risk factors that should prompt consideration of these diseases are outlined in Table 5.

• #20 Otalgia Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/845173-workup

  In the author’s study group, 44% of patients without an obvious cause for their ear pain experienced spontaneous resolution. […] Those in whom symptoms do not resolve must be seen on a regular basis. Follow-up is essential in these cases because of the possibility of discovering a tumor that was initially too small to detect. […] CT scanning can reveal significant information about the temporomandibular joint or can be used to diagnose intratemporal lesions. […] If indicated by clinical or audiometric suspicion, an MRI may be necessary to define a cerebellopontine angle or other intracranial tumor. […] The high prevalence of dental-related otalgia in the author’s study group underscores the need for an alliance with a person well trained in temporomandibular joint-related disorders. […] Maintain a high index of suspicion for an occult upper respiratory tract tumor, intracranial tumor, intratemporal disease, sinus-related pathology, autoimmune disease, and Eustachian tube dysfunction. Consider laboratory evaluation.

• #21 Swimmer’s ear | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/swimmers-ear

  Swimmer’s ear is diagnosed by physical examination. The skin of the ear canal will appear red, scaled and peeling when examined using an otoscope. The eardrum may be inflamed and swollen. Microscopic examination of the discharge in the ear canal will, in most cases, tell the doctor whether the infection is caused by bacteria or fungi. The diagnosis can be confirmed by culturing a swab of pus. In the case of malignant otitis externa, further tests – including skull x-rays, magnetic resonance imaging (MRI) and computed tomography (CT) scans – are taken. […] Treatment depends on the degree of bone infection (osteomyelitis), but is generally lengthy and involves prolonged courses of antibiotics. Surgery may also be necessary.

• #22 Ear pain – Wikipedia

  https://en.wikipedia.org/wiki/Ear_pain

  Ear pain, also known as earache or otalgia, is pain in the ear. Primary ear pain is pain that originates from the ear. Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt. […] In general, the reason for ear pain can be discovered by taking a thorough history of all symptoms and performing a physical examination, without need for imaging tools like a CT scan. However, further testing may be needed if red flags are present like hearing loss, dizziness, ringing in the ear or unexpected weight loss. […] Management of ear pain depends on the cause. If there is a bacterial infection, antibiotics are sometimes recommended and over the counter pain medications can help control discomfort. […] While some disorders may require specific imaging or testing, most etiologies of ear pain are diagnosed clinically. Because the differential for ear pain is so broad, there is no consensus on the best diagnostic framework to use. […] If red flags are present it may be necessary to do additional workup such as a CT scan or biopsy to rule out a more dangerous diagnosis. Such diagnoses include malignant (or necrotizing) otitis externa, mastoiditis, temporal arteritis, and cancer.

• #23 Otalgia

  https://www.racgp.org.au/afp/2016/july/otalgia

  Otalgia is frequently seen in general practice. The aims of this article are to outline the most common causes of otalgia seen in general practice, and provide a pragmatic approach to initial assessment and deciding when to refer for specialist review. The most common cause of primary otalgia is infection. Other causes require a greater index of suspicion. Specialist referral could be made if there are complications of primary otalgia or if a secondary cause needs to be excluded in a patient with a normal otology examination. The aetiology of otalgia can be broadly divided into primary and secondary causes. Primary causes are those that originate in the ear and are a direct cause of pain through stimulation of nociceptor fibres. Secondary causes are those that the patient feels have originated from the ear, but in fact are referred from other sources and require a higher index of suspicion to determine the precise aetiology. The primary causes of otalgia are often benign and present as straightforward cases to the experienced GP. If the cause is not obvious, secondary causes of ear pain are considered. All cancers of the head and neck usually squamous cell carcinomas need to be considered as a secondary cause of otalgia in patients who have an otherwise normal otology history and examination. Outpatient specialist referral is indicated in patients who present with persistent or unexplained otalgia without an apparent cause and a normal examination. A complete otology history is essential for determining if the cause is primary and therefore a history should be routine in a patient presenting with otalgia. The severity of otalgia alone is unlikely to reflect the seriousness of the aetiology. A flexible nasal endoscopy can be performed by an otolaryngologist to exclude a lesion that may be a squamous cell cancer not visible to the GP. In a patient who presents with otalgia that does not have a clear cause, or if the suspected cause does not respond to treatment as expected, consider red flags and exclude a more sinister cause for the symptoms.

• #24 Otalgia Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/845173-workup

  Frequently, the workup suggests that otalgia may be a problem of dental origin. […] A complete blood count may indicate an occult infection. Thyroid function and erythrocyte sedimentation rate (ESR) studies may reveal thyroiditis and temporal arteritis. […] Mnire disease can be diagnosed by history, audiometrics, and a battery of laboratory tests. […] In the absence of obvious fluid within the middle ear, aural fullness secondary to Eustachian tube dysfunction may manifest with a practically imperceptible bulging or retraction of the tympanic membrane. […] If autoinsufflation is not effective in relieving this pressure, consider a diagnostic myringotomy. […] Despite the full battery of testing, a group of patients always remains for whom an etiology is not evident. […] If not contraindicated, a brief course of nonsteroidal anti-inflammatory agents (NSAIDs) may be helpful.

• #25 ICD-10 Codes for ear pain | Earache – DocCharge

  https://doccharge.com/blog/icd-10-codes-for-ear-pain-earache/

  Ear pain (or otalgia) ranks as one of the leading complaints among children and adult evaluated in the primary care or emergency setting. Most patients will have one of three common diagnoses (acute otitis media [AOM], otitis externa, or otitis media with effusion [OME]), which are generally not serious. […] The first step in evaluating otalgia includes a comprehensive history and physical examination. Evaluation should exclude red flags and risk factors for a serious diagnosis. If found, then head neck CT and MRI, panendoscopy, including nasolaryngoscopy and direct visualization of the upper aerodigestive tract, can be ordered. […] Treatment of otalgia is dependent on the diagnosis. Infections cause most primary otalgia and are treated with antibiotics, while mechanical receive treatment with decongestants, nasal steroids, or myringotomy. […] Patients who have an unremarkable clinical evaluation and no red flags or risk factors for serious disease can be treated conservatively with analgesics and re-evaluated in 4 weeks.

• #26 Ear infection (middle ear) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ear-infections/diagnosis-treatment/drc-20351622

  Antibiotics might be helpful for some children and for adults with ear infections. But using antibiotics too often can cause the medicine to not work as well against the bacteria. Talk to your child’s healthcare professional about the pros and cons of using antibiotics. […] Usually after a watch-and-wait time, a healthcare professional might suggest using an antibiotic for an ear infection for: Children 6 months and older with moderate to severe ear pain in one or both ears for at least 48 hours or a temperature of 102.2 F (39 C) or higher. […] Children younger than 6 months who have acute otitis media are more likely to be treated with antibiotics without the watch-and-wait time. […] Chronic infection that causes a tear in the eardrum, called chronic suppurative otitis media, is hard to treat. Antibiotics drops put into the ear might treat the condition. You might get directions on how to suction fluids out through the ear canal before putting in the drops. […] Children who have infections often or who always have fluid in the middle ear will need to be watched. Talk to your child’s healthcare professional about how often to schedule follow-up appointments. Follow-up might include regular hearing and language tests.

• #27 Otalgia – Ear, Nose, and Throat Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-ear-problems/earache

  With acute pain, the most common causes are middle ear effusion with or without infection and external ear infection. […] With chronic pain (2 to 3 weeks), the most common causes are temporomandibular joint (TMJ) dysfunction, chronic eustachian tube dysfunction, chronic otitis media, chronic otitis externa, and migraine. […] TMJ dysfunction and migraine are common causes of otalgia in patients with a normal ear examination. […] An important differentiator is whether the ear examination is normal; middle and external ear disorders cause abnormal physical findings, which, when combined with history, usually suggest an otogenic etiology. […] Patients with a normal ear examination may have a visible oropharyngeal cause, such as tonsillitis or peritonsillar abscess. […] Chronic ear pain without abnormality on ear examination might be due to a TMJ disorder or migraine, but patients should have a thorough head and neck examination to exclude cancer. […] Most cases are due to infection of the middle or external ear. […] History and physical examination are usually adequate for diagnosis. […] Nonotologic causes should be considered when ear examination is normal.

• #28 Ear Infection Symptoms & Earache Evaluation | MinuteClinic®

  https://www.cvs.com/minuteclinic/services/earaches-and-ear-infections

  Most common causes of ear pain include: Ear infection (from bacteria or a virus), Earwax, Injury caused by cotton swab, Object in the ear, Pressure change (while flying, etc.), Sinus infection, Strep throat. […] Symptoms and signs of ear infections in children include: Drainage from the ear, Fussiness, Fever, Headache, Loss of appetite, More crying than usual, Pain that is worse when lying down, Pulling on the ear, Trouble hearing, Trouble sleeping, Trouble with balance. […] Antibiotics are effective only when a bacterial infection is the cause. They’re not effective against viruses or inflammation caused by irritants. […] Most ear pain should be evaluated if it does not go away after a day or two.

• #29 New AI Smartphone Tool Accurately Diagnoses Ear Infections

  https://www.upmc.com/media/news/030424-ai-diagnoses-infections

  A new smartphone app developed by physician-scientists at UPMC and the University of Pittsburgh, which uses artificial intelligence (AI) to accurately diagnose ear infections, or acute otitis media (AOM), could help decrease unnecessary antibiotic use in young children, according to new research published today in JAMA Pediatrics. […] The new AI tool, which makes a diagnosis by assessing a short video of the eardrum captured by an otoscope connected to a smartphone camera, offers a simple and effective solution that could be more accurate than trained clinicians. […] Acute otitis media is often incorrectly diagnosed, said senior author Alejandro Hoberman, M.D., professor of pediatrics and director of the Division of General Academic Pediatrics at Pitts School of Medicine and president of UPMC Childrens Community Pediatrics.

• #30 New AI Smartphone Tool Accurately Diagnoses Ear Infections

  https://www.upmc.com/media/news/030424-ai-diagnoses-infections

  Our tool helps get the correct diagnosis and guide the right treatment. […] AOM is often confused with otitis media with effusion, or fluid behind the ear, a condition that generally does not involve bacteria and does not benefit from antimicrobial treatment. […] To develop a practical tool to improve accuracy in the diagnosis of AOM, Hoberman and his team started by building and annotating a training library of 1,151 videos of the tympanic membrane from 635 children who visited outpatient UPMC pediatric offices between 2018 and 2023. […] Both models were highly accurate, producing sensitivity and specificity values of greater than 93%, meaning that they had low rates of false negatives and false positives. […] These findings suggest that our tool is more accurate than many clinicians, said Hoberman.

• #31 Ultrasound aids ear infection diagnosis • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/ultrasound-aids-ear-infection-diagnosis.html

  Unlike traditional ultrasound transducers needing gel or water coupling, these new CMUTs are optimised to operate through air in the human ear canal, the company reports. […] Using these novel transducers, along with hardware and algorithmic innovations, OtoNexus will place a high-precision ultrasound device in the hands of paediatricians, designed specifically to their needs and utilising their current workflow.

• #31 Ultrasound aids ear infection diagnosis • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/ultrasound-aids-ear-infection-diagnosis.html

  Otitis Media (OM), a middle ear infection, is the number one indication for antibiotic prescriptions for children and the leading cause for surgery. […] Multiple studies (including from the CDC) show diagnostic error rates averaging 50 percent, particularly in the key differentiation of viral from bacterial infection, and whether an antibiotic is appropriate. […] The current tool used to diagnose middle ear infections is the otoscope, which is essentially a magnifying lens, battery, and light source a virtually unchanged system since its introduction decades ago. […] A new device under development at OtoNexus Medical Technologies (Seattle, WA, USA) has the familiar form factor of a traditional otoscope, but uses a novel air-coupled ultrasound technology to provide the data physicians need to instantly and accurately assess middle ear infections, the company reports.

• #32 Improving ear infection diagnoses | OSF HealthCare

  https://www.osfhealthcare.org/blog/improving-ear-infection-diagnoses/

  If you are a parent, theres a decent chance youve had to comfort a screaming child with an ear infection. […] Studies show middle ear infections are among the most frequent diseases diagnosed among children and one of the most common reasons for prescribing antibiotics worldwide. […] Understanding the need to reduce antibiotic use, OSF Ventures invested in PhotoniCare, Inc., a company thats developed a more precise way to detect ear infections for both children and adults. […] The device, known as the OtoSight Middle Ear Scope, works much like a traditional otoscope that is used to look inside the ear. […] Otoscopes have been used to diagnose ear infections for more than 150 years, but there is only a 50% accuracy rate when using the tool. The OtoSight Middle Ear Scope improves that to more than 90% accuracy.

• #32 Improving ear infection diagnoses | OSF HealthCare

  https://www.osfhealthcare.org/blog/improving-ear-infection-diagnoses/

  At two OSF OnCall Urgent Care sites, the device has been integrated into the workflow any time a pediatric or adult patient comes in with ear fullness, ear pain or ear drainage. […] Diagnosing ear infections is difficult, and the wrong choice can lead to unnecessary use of antibiotics and even surgery. Improving the accuracy of middle ear infection diagnoses could save millions of dollars in the U.S. alone. […] If youre going to your pediatrician or urgent care quite often for frequent ear infections or what you believe are ear infections, your child is at risk of building a resistance to antibiotics over time and likely experiencing unnecessary side effects, Susan said. We want to stop that from happening. By using the OtoSight, we have the potential to improve diagnosis and treatment in patients and reduce future costs.

• #33 Ear infection diagnosis and treatment options | Norton Healthcare Louisville, Ky.

  https://nortonhealthcare.com/patient-resources/norton-now/ear-infection/

  Infections of the inner, middle or outer ear can affect you at any age, especially if you have a history of ear infections, sinus infections, allergies or exposure to tobacco smoke. Some ear infections, such as middle ear infections, may need antibiotic treatment, but many can get better without antibiotics. […] When we think of an ear infection, it’s usually a middle ear infection, or acute otitis media. The middle ear refers to the part of the ear behind your eardrum. Anything that prevents fluid from draining from the middle ear, such as allergies, common cold or an upper respiratory infection, can cause a middle ear infection. […] A medical provider may need to see you or your child to look for a red or bulging eardrum or fluid in the middle ear. […] Most acute ear infections go away on their own and don’t require treatment. However, if your pain has lasted longer than two to three days and/or you have symptoms highlighted above, contact your health care provider. […] If your pain is severe, your doctor may need to drain fluid from your ear. You may be referred to an otolaryngologist, also known as ear, nose and throat or ENT doctor. Ear infections that go untreated can cause hearing loss.

• #34 Ear Infection Symptoms in Children & Adults

  https://www.webmd.com/cold-and-flu/ear-infection/understanding-otitis-media-symptoms

  The most common sign of an ear infection is an earache. It can be either a sharp, sudden pain or a dull discomfort that just doesn’t go away. […] You’ll need a doctor’s exam to get an official diagnosis. […] Overall otitis media symptoms can include: Ear pain, Ear discharge (you may feel or see a warm liquid trickling out from your ear), Sore throat, Fever that’s often between 100 F and 104 F, Headache, Trouble keeping your balance. […] Call your doctor or seek help right away if your child: Has severe ear pain, Has fluid coming out of their ear, Has no energy, Isn’t sleeping or eating well, Won’t stop crying, no matter what you do to try to soothe them, Has a stiff neck (can’t touch their chin to their chest), Is running a fever, especially in babies younger than 3 months, Has muscle weakness on one side of their face (look for a crooked smile), Is having trouble walking/doesn’t seem steady, Has swelling behind their ear (it may look red or pink), Is vomiting, Feels very sick and you’re worried.

• #35 Ear Infection Symptoms in Children & Adults

  https://www.webmd.com/cold-and-flu/ear-infection/understanding-otitis-media-symptoms

  If you’re an adult, call your doctor and get immediate medical care if: You have intense pain in or around your ear. You have a fever over 102.2 F. You have fluid coming from your ear. You can’t move part of your face. […] Don’t put off seeing a doctor. Untreated ear infections can cause serious, and sometimes long-term, issues, such as: Hearing loss. Sometimes, this is temporary, and your hearing will return to normal once your infection clears. But severe infections or infections that go away and come back can cause permanent hearing damage.

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