Otalgia and otorrhoea: causes by anatomical site

What it is

Otalgia is pain in the ear. Otorrhea is drainage of liquid from the ear.

Causes and risk

The causes are grouped by the site they come from.

External auditory canal:

• Wax.
• Keratosis obturans.
• Perichondritis.
• External otitis.

Middle ear:

• Acute otitis media.
• Chronic otitis media.
• Middle ear effusion.
• Acute barotrauma.
• Foreign body.

The differential diagnosis of otalgia is set out on the same page in three groups, each of them divided into infection, trauma and other:

• External ear. Infection: auricular cellulitis, external canal abscess, herpes simplex or zoster, otitis externa. Trauma: burns, hematoma, lacerations. Other: cerumen impaction, foreign body, neoplasm of the external canal.
• Middle or inner ear. Infection: acute otitis media, mastoiditis, myringitis, otitis media with effusion, skull base infections. Trauma: barotrauma, traumatic perforation. Other: cholesteatoma, neoplasm, Wegener's granulomatosis.
• Referred pain. Infection: Ramsay Hunt syndrome, tonsillitis, tracheitis. Trauma: cervical arthritis, thyroiditis. Other: glossopharyngeal neuralgia, neoplasm of the oral cavity, larynx or pharynx, teeth, and TMJ syndrome.