Auralgie

Auralgie, also called otalgia or earache, is pain in one or both ears. It is a symptom rather than a disease and may originate from structures in the ear itself or reflect referred pain from adjacent regions such as the teeth, sinuses, or throat.

Most common causes are infections of the ear, including acute otitis media and otitis externa, and cerumen impaction. Other conditions may contribute, such as Eustachian tube dysfunction, temporomandibular joint disorders, dental abscess, sinusitis, pharyngitis, foreign body, barotrauma, or trauma to the ear or head. In rare cases, tumors or systemic disease can present with otalgia.

Pain is the defining symptom; it may be sharp or dull and can be accompanied by fever, hearing loss, fullness, itching, discharge from the ear, vertigo, or tinnitus. In children, irritability and crying are common. Red flags include severe signs, persistent unilateral ear pain with fever, or seizure.

Evaluation relies on history and a physical exam, especially otoscopy to inspect the tympanic membrane and canal. The clinician assesses for signs of infection, blockage, or TMJ dysfunction, and may examine the mouth and nose for referred sources. Additional tests are reserved for persistent or atypical cases.

Management targets the underlying cause and pain relief. Analgesics such as acetaminophen or ibuprofen are commonly used. Otitis externa or media may require topical or systemic antibiotics as appropriate, wax impaction may be removed, and underlying dental or sinus conditions treated. Referral to an ENT is indicated for persistent, recurrent, or unclear cases.

Most cases resolve with appropriate care. Complications are uncommon but can include tympanic membrane rupture, chronic otitis media, mastoiditis, or intracranial spread in rare cases. Prevention focuses on avoiding ear trauma, treating upper respiratory infections promptly, and vaccination where applicable.