Differential Diagnosis for Ear Pain after Firework
- Single most likely diagnosis
- Acoustic Trauma: This is the most likely diagnosis due to the loud noise from the firework, which can cause damage to the eardrum or the middle ear bones, leading to ear pain.
- Other Likely diagnoses
- Earwax impaction or rupture of the eardrum from the blast: The intense sound wave from the firework can dislodge earwax, causing impaction, or even rupture the eardrum.
- Middle ear infection: The shockwave from the firework can also introduce bacteria into the middle ear, leading to an infection.
- Otalgia from Eustachian tube dysfunction: The pressure change from the blast can cause Eustachian tube dysfunction, leading to ear pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Perforated eardrum with cerebrospinal fluid leak: Although rare, a perforated eardrum from the blast can lead to a cerebrospinal fluid leak, which can be life-threatening if not treated promptly.
- Temporal bone fracture: A severe blast can cause a temporal bone fracture, which can lead to serious complications, including facial paralysis, hearing loss, and meningitis.
- Rare diagnoses
- Cochlear hydrops: The intense sound wave can cause an imbalance of fluid in the inner ear, leading to cochlear hydrops, a condition that can cause vertigo, hearing loss, and ear fullness.
- Patulous Eustachian tube: The pressure change from the blast can cause the Eustachian tube to remain open, leading to a patulous Eustachian tube, which can cause ear fullness, hearing loss, and autophony.