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Earache is very common, particularly in small children. The two most prevalent causes of earache are infection of the outer ear (otitis externa) and infection of the middle ear (otitis media). Less common causes include a perforated eardrum due to a middle ear infection, head injury, referred pain from other head or neck structures, loud noise or poking a foreign body into the ear canal.


Because of the possibility of hearing loss and other complications, it is important to see your doctor promptly if you or your child experience ear pain.



What causes earache?


  • Skin infection of the outer ear or ear canal (often occurring after swimming)
  • Infection of the middle ear and eardrum (very common in children aged 6 months to 2 years)
  • Blockage of the Eustachian tube in sinusitis
  • Changes in air pressure when flying, especially as the plane descends



What are the symptoms?


Outer ear infection


  • Earache, which can range from a mild itch to severe pain
  • Loss or dullness of hearing
  • Ringing or buzzing in the ear
  • Blocked or full sensation in the ear
  • Swelling of the ear
  • Thick discharge from the ear


Middle ear infection


  • Earache, usually moderate to severe
  • Loss or dullness of hearing
  • Ringing or buzzing in the ear
  • Blocked or full sensation in the ear
  • Fever
  • Occasionally, discharge from the ear as the eardrum ruptures and the infected fluid drains out
  • In babies, crying, poor sleep, irritability and pulling at the ears
  • With ‘glue ear’ there may be no symptoms at all except difficulty in hearing, which may not be picked up until your child goes to school



What is the treatment?


Outer ear infections are usually treated with ear drops. Over-the-counter pain-relievers such as paracetamol, low-dose ibuprofen or a combination of both Paracetamol 500mg + Ibuprofen 150mg may be helpful for the first few days.


Middle ear infections may be more serious. Most cases are treated with oral antibiotics for 10-14 days but antibiotics are not always necessary. Sometimes an oral decongestant can be helpful. Pain-relievers as above may be needed for the first few days – but don’t give these to your child unless advised by your doctor. Ask your pharmacist for a specialised pain-reliever for babies and small children, such as Fenpaed.


For ear pain while flying, you can:


  • suck sweets or chew gum when the plane begins to descend
  • yawn widely and move your jaw from side to side
  • pinch your nose and blow gently until your ears ‘pop’
  • use a decongestant nasal spray an hour before the plane begins its descent
  • ask the cabin staff for a eucalyptus pad or heated inhalation to sniff as the plane descends
  • feed babies and give small children a drink while descending, to encourage them to swallow.




More Information

E Medicine Health - Earache




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