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Had fungal infection on external ear. Been through oral treatment and ear drops. There is again sever pain in ears at midnight. Suggest required treatment?

my 11 years old daughter had fungal infection of external ear about 45 days back for which she under treatment in form of oral and ear drops. She recovered in ten days. She did not have any fever and also her tympanic membrane was normal on examination. She then also had tenderness of mastoid on deep pressure more than contralateral side on comparison. Ten about 25 days later she has a very peculiar pain i her same ear. This pain starts around midnight, while she is still awake or even if she is sleeping, and it lasts till about 2am in night. Pain appears i bouts and lasts for about one or two seconds but is very severe and is associated with a grating sensation or sound in earn. This sensation lasts throughout till 2am and only increases during sharp painful spurt. She is afebrile and normal as and active throughout the day. Presently she has some tenderness on her Mastoid of same side as well as in preauricular region. Her ext ear and the tympanic membrane is normal on appearance and there is no discharge from the earn. Kindly suggest any investigation required or any treatment.
Asked On : Sun, 7 Apr 2013
Answers:  1 Views:  17
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ENT Specialist 's  Response

Thanks for writing to H.C.M. for your query.

I have gone through your query regarding severe pain in ear of your daughter, and she had been given treatment for fungal infection in her external ear of same side about 45 days back. she had completely recovered from fungal infection.

Now shooting pain in ear indicates towards recurrence of fungal infection, but as you said that now her ear canal and ear drum is normal therefore I rule out fungal infection. The other possibilities are-

(a) Acute otitis media.

(b) Reffered Otalgia.- Means here ear remains O.K. and pain gets reffered to ear from- Molar teeth, posterior half of tongue, tonsils, throat.

To reach to final diagnosis you are advice for these investigations-

(a) C.T. scan ear (HRCT) to rule out pathology.

(b) Audiometery- Pure tone and Impedance audiometery.

A thorough examination and co-relation of inferences of investigations will help in reaching to correct diagnosis which may accordingly be managed.

Answered: Sun, 7 Apr 2013
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