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CHILDREN’S HEALTH: EARACHES

An earache is any pain or ache in the ear. Earaches may occur at any age from infancy on. However, they usually occur less and less often after the age of eight.

The most common cause of an earache is blockage of the Eustachian tube (which connects the nose with the middle ear). This tube may become blocked as a result of a nasal allergy, a head cold, infected adenoids (lymph glands in the passage between the nose and throat), swimming in fresh or chlorinated water, or flying in an airplane. This blockage causes a vacuum in the middle ear, changes in the pressure on the eardrum, and secretion of fluid into the airspace of the middle ear. If obstruction of the Eustachian tube continues, it may rapidly develop into an infection of the middle ear with pus (otitis media). If the eardrum ruptures (breaks), discharge begins to drain out of the ear.

An earache may also result from foreign objects in the ear canal, a buildup of ear-wax, pain in the jaw or molar teeth, or boils in the ear canal. Boils can be caused by scratching or digging in the ear with bobby pins, hairpins, fingernails, or cotton swabs.

Complications of untreated middle ear infections include mastoiditis (infection of the bone behind the ear), meningitis, perforated eardrum, and draining ear. Both middle and outer ear infections can cause swollen, tender lymph nodes.

Signs and symptoms

Earaches may be mild or extremely painful. The pain may be constant, may come and go, or may occur only with chewing, burping, or nose blowing. Earaches may or may not be accompanied by fever or signs of a cold. They may or may not affect hearing. Progression to an infected middle ear (otitis media) usually causes intense, often throbbing pain. If the eardrum ruptures, pain quickly lessens. If there is a boil, a foreign body, a buildup of earwax or an infection in the ear canal, the pain is mild at first and gradually builds. Gentle pressure on the earlobe aggravates the pain.

If your child is too young to tell you where the pain is, prolonged crying should be considered a possible sign of an earache. An earache is especially likely if the crying infant also has a head cold or congested nose, pulls on his or her ear, has recently gone swimming, or has flown in an airplane.

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