Differential Diagnosis for Bilateral Ear Pain
- Single most likely diagnosis
- Eustachian tube dysfunction: The patient's symptoms of ear pain, feeling of needing to "pop" their ears, and difficulty hearing are consistent with Eustachian tube dysfunction, which can be caused by a variety of factors including allergies, colds, or sinus infections. The mild sore throat also supports this diagnosis.
- Other Likely diagnoses
- Otitis media with effusion (OME): The patient's symptoms of ear pain, difficulty hearing, and feeling of fullness in the ears could be consistent with OME, which is a common condition in adults and children.
- Otitis externa: Although the patient does not report any discharge or itching, otitis externa is still a possible diagnosis, especially if the patient has been swimming or using earbuds.
- Temporomandibular joint (TMJ) disorder: The patient's report of pain at the bottom of the ears and neck could be referred pain from the TMJ, which is a common cause of ear pain.
- Do Not Miss diagnoses
- Malignancy (e.g. nasopharyngeal carcinoma): Although rare, malignancies in the head and neck region can cause Eustachian tube dysfunction and ear pain, and would be devastating if missed.
- Acoustic neuroma: A benign tumor on the vestibulocochlear nerve can cause ear pain, hearing loss, and balance problems, and would require prompt diagnosis and treatment.
- Lyme disease: If the patient has been exposed to ticks, Lyme disease could be a possible diagnosis, as it can cause ear pain, hearing loss, and other systemic symptoms.
- Rare diagnoses
- Relapsing polychondritis: A rare autoimmune disorder that can cause ear pain, hearing loss, and other systemic symptoms.
- Wegener's granulomatosis: A rare autoimmune disorder that can cause ear pain, hearing loss, and other systemic symptoms, including respiratory and renal involvement.
- Otosclerosis: A rare condition that causes abnormal bone growth in the middle ear, leading to hearing loss and ear pain.