Ear pain

Data gathering

  • Red flags – head injury, progressive
  • Others – swimming, teeth, ear discharge, hearing loss, tinnitus, facial weakness
  • Examine – mastoid, ENT, CN7 (facial)

 

Clinical management

  • Investigations
    • swabs
  • Treatment (depending on cause)
    • Acute otitis media
      • analgesia
      • review after 4 days
      • amoxicillin 5d if systemically unwell/chronic disease/>4d duration/<2yo + bilateral/otorrhoea
    • Eustachian tube dysfunction
      • valsalva
      • steroid nasal spray
    • Otitis externa
      • keep dry
      • otomize
    • Perforated ear drum
      • keep dry
      • review in 4 weeks – refer if not healed
    • TMJ dysfunction
      • analgesia
      • stress
      • dentist – dental guard