What is the cause of the patient's right ear pain, which has persisted for over 10 days and is exacerbated by wearing a hearing aid (HA), resulting in sleep disturbance?

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Differential Diagnosis for Right Ear Pain

  • Single most likely diagnosis
    • Otitis externa: This is a common condition that causes ear pain, especially if the patient has been using a hearing aid, which can irritate the ear canal and increase the risk of infection. The fact that the hearing aid was causing pain and the patient hasn't been able to wear it supports this diagnosis.
  • Other Likely diagnoses
    • Cerumen impaction: The use of a hearing aid can push earwax deeper into the ear canal, causing impaction and subsequent pain.
    • Eustachian tube dysfunction: This condition can cause ear pain and discomfort, especially if the patient has a cold or allergies.
    • Otosclerosis: This is a condition that affects the middle ear and can cause hearing loss and ear pain.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Malignant otitis externa: This is a rare but serious condition that can occur in patients with compromised immune systems, such as those with diabetes or HIV.
    • Temporal bone fracture: Trauma to the head or ear can cause a fracture of the temporal bone, leading to severe ear pain and potentially life-threatening complications.
    • Mastoiditis: This is an infection of the mastoid bone, which can spread to the brain and cause serious complications if left untreated.
  • Rare diagnoses
    • Relapsing polychondritis: This is a rare autoimmune disorder that can cause inflammation and pain in the ears, as well as other parts of the body.
    • Ramsay Hunt syndrome: This is a rare condition caused by the varicella-zoster virus, which can cause ear pain, facial weakness, and hearing loss.
    • Ear cancer: Although rare, cancer of the ear can cause pain, hearing loss, and other symptoms, and should be considered in the differential diagnosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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