Differential Diagnosis for Ear Pain
Single Most Likely Diagnosis
- Otitis Media: This is the most common cause of ear pain, especially in children. It is an infection of the middle ear that can be caused by bacteria or viruses, often following an upper respiratory tract infection. The symptoms include ear pain, fever, and hearing loss.
Other Likely Diagnoses
- Otitis Externa: Also known as swimmer's ear, this is an infection of the outer ear canal. It can be caused by bacteria or fungi and is often associated with water exposure, trauma to the ear canal, or excessive ear cleaning. Symptoms include ear pain, itching, and discharge.
- Eustachian Tube Dysfunction: This condition occurs when the tube that connects the middle ear to the back of the throat (Eustachian tube) does not open and close properly, leading to a feeling of fullness and pain in the ear.
- Earwax Impaction: The accumulation of earwax can cause ear pain, hearing loss, and a feeling of fullness in the ear. It is a common issue that can often be treated with ear drops or professional ear cleaning.
Do Not Miss Diagnoses
- Mastoiditis: This is a serious infection of the mastoid bone, located behind the ear. It can be a complication of untreated otitis media and requires prompt medical attention. Symptoms include severe ear pain, fever, and swelling behind the ear.
- Petrous Apicitis: A rare but serious infection of the petrous part of the temporal bone. It can cause severe ear pain, headache, and neurological symptoms, and requires immediate medical intervention.
- Ramsay Hunt Syndrome: Caused by the varicella-zoster virus, this condition leads to facial paralysis, ear pain, and sometimes vertigo and hearing loss. Prompt treatment with antivirals can improve outcomes.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation and destruction of cartilage in various parts of the body, including the ears. It can lead to ear pain, redness, and swelling.
- Temporal Bone Fracture: A fracture of the temporal bone can cause severe ear pain, hearing loss, and other neurological symptoms. It is usually the result of significant head trauma.
- Ear Cancer: Although rare, cancer of the ear (either the outer ear, ear canal, or middle ear) can cause persistent ear pain, hearing loss, and discharge. It requires early diagnosis and treatment for the best outcomes.