Differential Diagnosis for Otalgia with Forehead Pressure
- Single most likely diagnosis
- Sinusitis: This is the most likely diagnosis given the combination of otalgia (ear pain) and forehead pressure. The Eustachian tube, which connects the middle ear to the back of the nose and throat, can become blocked due to sinus inflammation, leading to ear pain. Forehead pressure is a common symptom of sinusitis due to the location of the frontal sinuses.
- Other Likely diagnoses
- Eustachian Tube Dysfunction: This condition can cause ear pain and is often associated with nasal congestion or sinus pressure, which could explain the forehead pressure.
- Tension Headache: Tension headaches can cause forehead pressure and sometimes radiate to the ears, causing otalgia.
- Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause ear pain and might be associated with forehead or facial pain due to the referred pain patterns of the trigeminal nerve.
- Do Not Miss diagnoses
- Meningitis: Although less likely, meningitis is a serious condition that can present with headache, fever, and sometimes ear pain due to the inflammation of the meninges. The forehead pressure could be part of a more severe headache.
- Mastoiditis: An infection of the mastoid bone in the skull, which can cause ear pain and is a complication of untreated or severe otitis media. Forehead pressure could be part of the overall symptom complex if the infection spreads or causes significant inflammation.
- Temporal Arteritis: This condition, also known as giant cell arteritis, can cause headache and facial pain, including ear pain, and is a medical emergency due to the risk of vision loss.
- Rare diagnoses
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which could cause severe facial pain, including the forehead and ear area, though it's less commonly associated with forehead pressure.
- Petrous Apicitis: A rare complication of otitis media where the petrous part of the temporal bone becomes infected, leading to severe ear pain and potentially forehead pressure due to the location and spread of the infection.
- Nasopharyngeal Carcinoma: A rare type of cancer that could cause Eustachian tube obstruction leading to ear pain and might also cause forehead pressure if the tumor invades nearby structures.