Ear Pain Scheme

Question 1

• Pain with traction on the auricle + pressure on the tragus suggests…
• Tug Test + pressure on tragus

Answer 1

External Ear Problem, usually otitis externa

Question 2

Infection of perichondrium but sparing of the earlobe

Answer 2

• Perichondritis. If not sparing, then you’re thinking cellulitis

Question 3

Triad of ipsilateral facial paralysis, ear pain, and vesicles in the auditory canal and auricle

Answer 3

• Ramsay Hunt Syndrome in Herpes Zoster Oticus

Question 4

Hx of swimming

Answer 4

Pseudomonas aeruginosa, Staphlyococcus aureus. Otitis Externa

Note: For malignant otitis externa = focus on pseudomonas aeruginosa treatment.

Question 5

Patient feels pain worse when supine.

Answer 5

Acute Otitis Media

Sx: Bulging tympanic membrane with impaired mobility/presence of effusion.

Question 6

“Glue Ear”

Answer 6

Otitis Media with effusion = accumulation of fluid in the ear without infection.

Question 7

“Racoon eyes” (periorbital ecchymosis).

Answer 7

Basilar Skull fracture

Question 8

“ANCA” - antineutrophilic cytoplasmioc antibodies

Answer 8

Wegner’s granulomatosis

Question 9

Bruxism, degenerative join disease, poorly-fitting dentures

Answer 9

TMJ

Question 10

Meniere’s Disease = where is the discomfort

• CN 5
• CN 7
• CN 9
• CN 10

Answer 10

• CN 5 = Discomfort in front of the ear (TMJ)
• CN 7 = Discomfort behind the ear
• CN 9 = Discomfort deep in the ear
• CN 10 = Discomfort in ear canal

Question 11

Hx of Airplane travel = pain

Answer 11

Eustachian Tube Dysfunction: Formation of vacuum causing fluid to be drawn in the middle ear space, forming a condition known as serous otitis media. “Glue Ear????”