Otalgia (synonyms: ear neuralgia; otagra; otalgia; otalgia; otodynia; otoneuralgia; ICD-10-GM H92.-: Otalgia and otorrhea) is the medical term for ear pain. It is the leading symptom for all inflammatory diseases of the ear, middle ear and outer ear.
The following forms of otalgia can be distinguished:
- Primary otalgia – the cause of the ear pain here is the ear itself.
- Secondary otalgia – here only a nervous pain transmission to the ear takes place via sensory fibers of the trigeminal nerve, facial nerve, glossopharyngeal nerve, vagus nerve or the second and third cervical nerves (C2, C3)
In children, otalgia is often due to acute otitis media (middle ear infection). In adults, otalgia often has direct local causes.
Otalgia can be a symptom of many diseases (see under “Differential diagnoses”). The prevalence (disease incidence) is 3-6% in a general medical practice. Course and prognosis: Prognosis depends on the nature and severity of the underlying disease. Otalgia may be associated with a peritonsillar abscess (abscess formation (encapsulated cavity filled with pus) in the loose connective tissue surrounding the palatine tonsil), which can lead to life-threatening sequelae such as laryngeal edema, cervical phlegmon (diffuse bacterial inflammation of the soft tissues of the neck, usually spreading very rapidly), or meningitis (meningitis). In cases of otalgia without ear involvement, common triggers include cervical spine disease and temporomandibular joint arthropathy (degenerative joint changes in the area of the temporomandibular joint that lead to pain). Malignant (malignant) diseases must be considered in elderly patients and also in cases of nicotine and alcohol abuse.
Preventable dangerous courses – specific problems – in ear pain are:
- Overlooking rare other dangerous causes (as otitis).
- In otitis media acuta (AOM; acute otitis media):
- Rare complications such as mastoiditis (redness retroauricular (“behind the ear”), protruding auricle; acute inflammation in the mastoid process (processus mastoideus) of the temporal bone with bone fusion), mastoid abscess, meningitis (meningitis), inner ear involvement (labyrinthitis), facial nerve palsy.
- Very rare complications such as intracranial abscess (formation of a pus cavity within the brain), empyema (accumulation of pus in a preformed body cavity or hollow organ), thrombosis or similar.
- Antibiotic administration does not prevent complications
- Prolonged hearing loss and possibly resulting speech development delay.
