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What Is The Cause And Treatment For Ear Pain?

Posted on Mon, 17 Nov 2014

Question: Hello I am writing on behalf of my 14 year old son. He had severe ear pain 1.5 months ago in one ear only. His pediatrician called it swimmer's ear and a middle ear infection, placing him on antibiotics for 2 weeks. There was some relief but the pain continued. A second pediatrician put him on a different antibiotic, but it did not ease the pain, nor feeling of swelling in the ear and pain in front/behind the ear. We subsequently consulted an ENT physician who did a variety of tests (blowing air in the ear, a hearing test) and said there was nothing wrong with my son's ears. A follow up check revealed the same thing. Meanwhile, my son has pain when he hiccups, and feels as thought the ear is crunching/crumpling up and the ear drum is bouncing when he hiccups. He also had pain in front of the ear, going down the neck a little. We consulted his dentist, who said there was nothing obvious, just perhaps a mild need for him to get braces. At this point, as a parent, I don't know where to turn. I know my child and he never complains about anything and is generally quite healthy. He really feels there is something wrong with his ear. I am now considering taking him to an oral surgeon for a TMJ evaluation, as I have no other ideas. Any advice deeply appreciated.He also has ringing in the ear that does not go away.

Answered by Dr. Naveen Kumar Nanjasetty (45 minutes later)

Brief Answer:
Eustachian tube block/dysfunction...

Detailed Answer:
Hi

Thanks for posting the query and an elaborate history. I have understood the problem and will try my best to guide you accordingly.

1. The description given by you indicates that the child is suffering from sinusitis with Eustachian tube (the tube connecting nose and the ear) block/dysfunction. The earache is because of the pressure created in the middle ear by the Eustachian tube block. Tinnitus is also one of the commonest symptoms of Eustachian tube block/dysfunction.

2. Antibiotics alone will not be sufficient enough to treat his condition. He will require the following:
a. Continue with the steroid nasal spray to reduce the sinus congestion and relieve the Eustachian tube block. A saline nasal spray to keep the nasal mucosa moist and keep the sinus and Eustachian tube patent.
b. A mucolytic such as ambroxol or bromhexine for thinning out the secretions, if any, in the sinuses.
c. Encourage him to do steam inhalation and drink lots of warm water
d. Avoid giving him coffee/chilled food or beverages.

3. You can definitely take an opinion from the maxilo-facial surgeon to rule out TMJ issues and impacted molar tooth if any.

If the symptoms are not getting better, get a CT scan of the paranasal sinuses done.

Hope this clarifies the doubts. I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T