Various reasons for earache

Consult ENT specialist for  diagnosis, treatment

I am 15-year-old girl. I have experienced earache since I was a child. Both my ears ache even these days. Usually I feel the pain once a week — the pain is mild at times, and acute in some cases. Sometimes, I feel my ears are full and hear noise inside my ears. What could be the reason for this? — Anonymous

I presume that you must have been examined by an ENT specialist at some point in your life. There are several aspects to be looked upon in your case from a simple impacted wax to chronic inflammation like CSOM (Chronic Suppurative Oititis Media). You have not mentioned three other classical ear problem symptoms of any discharge, dizziness, and any hearing loss. I will accordingly try to tackle your problem as per your above symptoms.

The ear is divided into three parts-external, middle and inner ear. Each part have their own function and subsequently can be the cause of your symptoms. The ear fullness part can thus be due to plethora of causes.

Tinnitus is the medical term for “hearing” noises in your ears when there is no outside source of the sounds. Tinnitus is often called “ringing in the ears,” but it may also sound like blowing, roaring, buzzing, hissing, humming, whistling, or sizzling. The noises you hear can be soft or loud. You may even think you are hearing air escaping, water running, the inside of a seashell, or musical notes. It is not known exactly what causes a person to “hear” sounds with no outside source of the noise. However, tinnitus can be a symptom of almost any ear problem, including, ear infection, wax, hearing loss, Meniere’s disease. Alcohol, caffeine, antibiotics, aspirin, or other drugs can also cause ear noises. Sometimes, it is a sign of high blood pressure, an allergy, or anemia Rarely, tinnitus is a sign of a serious problem like a tumour, aneurysm or even conditions like otosclerosis, a disease that results in stiffening of the small bones in the middle ear.

Thus, the pain can be due to wax, foreign body, sinusitis, and different type of ear infections like otitis externa, mastioditis, CSOM, ear drum perforation, dental abscess or even due to your jaw joint problem. One of the most important structures in your inner ear is the mastoid bone. Although it’s called a bone, the mastoid doesn’t have the typical structure associated with other bones in the human body. The mastoid must receive air from other parts of the ear, including the Eustachian tube, to function properly. If an infection develops in your middle ear and blocks your Eustachian tube, it may subsequently lead to an infection in the mastoid bone. This serious infection is known as mastoid bone infection of the skull, or mastoiditis. The most common cause of mastoiditis is a middle ear infection that has been left untreated. It can spread to the inner ear, invading the sacs of the mastoid bone, without treatment. This can cause the mastoid bone to begin to disintegrate. Although the condition is most common in children, it can also occur in adults.

In conclusion, since you speak of your problem arising since childhood, it would be most likely a chronic disorder like CSOM or a simple manifestation like excess wax accumulation or could even be a neglected mastoiditis. Thus foremost, do consult an ENT specialist for thorough examination because like I have always barked upon the dictum,’once correct diagnosis is made, treatment part becomes easy, it just follows’.

The doctors on THT Medical Board are

•    Dr Sanduk Ruit Medical Director, Tilganga Eye Hospital

•    Dr Bhagwan Koirala Cardiac Surgeon,TUTH

•    Prof Upendra Devkota Chief of Neurosurgery, National Institute of Neurological and Allied Sciences

•    Dr Kundu Yangzom Chief of OBGYN Services, Patan Hospital•    Dr Kishore PandeyPediatrician, CIWEC

•    Dr Sameer AryalDentist, Advanced Dental Care

•    prof Dr Dwarika P Shrestha Head of Dermatology Department, Teaching Hospital and Consultant, Dermato-Venereologist, B&B Hospital

•    Dr Ranjeet s BaralConsultant cardiologist, GP and Aeromedical Examiner at Ganga Lal, VAYODHA, Advanced Polyclinic and Norvic Hospital

•    Dr Prativa Shrestha Das is a Consultant Dermatologist and Aesthetician at Vayodha Hosptial, Balkhu

•    Dr Dilip Das is a Dentist at Vayodha Hospital, Balkhu

•    Dr Bharat Rawat is Consultant Cardiologist and Head of Cardiology Department at Norvic International Hospital Katmandu, Tripureshwor

•    Dr Uttam Kumar Sharma, is Associate Professor of Urology at TU Teaching Hospital and Urologist and Kidney Transplant Surgeon at Chirayu Hospital and Medical Institute, Basundhara, Kathmandu