I have had an on going problem with pain in my ears, the left more severe than the right. I worked as a DJ in nightclubs for the past several years. I had to wear ear plugs because my ears are sensitive to loud music and noise levels others find comfortable I find painful. In wearing foam ear plugs I noticed at times that my left ear would get tight and my ear canal would itch. I quit working in loud environments six months ago in hope that this would correct the problem but it did not. My GP prescribed me with Guaifed PD which seemed to help but the pain would always return. I consulted an ENT when I awoke one day with a sensation of fire shooting out of my left ear. This ENT gave me a shot,some decongestants and antibiotics, the pain subsided but returned. Both doctors said they saw nothing abnormal except for a mild redness or inflamation. Since I quit my job DJing I have moved and had to switch ENTs. In my latest trip to the doctor he said he saw nothing abnormal in my ear. After a complete hearing test the audiologist said I had above average hearing with only a slight deficiency in word recognition in my right ear(@30 dBHL 88% in right & 92% in left ear).
On returning to the ENT he said the audio exam showed nothing abnormal. I
am now taking Guaitex La which seems to have almost no effect. The pain and
pressure I feel is at times almost unbearable. When I was younger I had to
have a cyst taken out of my ear lobe. Could I have a cyst in my left ear
making a normal discomfort unbearable?
The audiological exam evaluation stated:
Pure Tone Average was
Left ear 3.3 Db
Right ear 1.6 Db
with air conduction and bone conduction revealing normal sensitivity
bilaterally
Impedance/Otoscopic Examination
Tympanometry showed a physical volume of .3 ml for both ears.
Compliance values for right ear were 1.1ml at 40 DPA and 1.0ml at 0 dpa
for the left ear. Ipsilateral reflexes were obtained at normal sensation
levels for the right ear for the frequencies 1000 HZ and 2000 HZ.
Ipsilateral reflexes were obtained for the left ear at the frequence 1000 HZ \
and were slightly elevated for the frequency 2000 HZ.
Reply: ------------------------
Ear pain (otalgia) is not always caused by an abnormality or medical
disorder of the ear itself. There are several sensory nerves which
innervate the outer and middle ear while also innervating other areas of
the head and neck. This fact provides the basis for the phenomenon known
as "referred otalgia" - pain felt in the ear that originates from a
disorder at another location. Common examples of this phenomenon include
otalgia occuring with jaw joint dysfunction (TMJ disorders) or otalgia
that occurs with throat conditions (eg acute tonsillitis). In fact,
otalgia can be the primary symptom of an irritation on the lining of a
vocal cord. The information you have provided suggests that it is
possible that the ear pain you experience is not originating in the ear
itself. One of the most common causes of referred otalgia are jaw joint
or myofascial pain syndromes. You might consider a consultation with a
dental specialist with expertise in TMJ or myofascial pain disorders.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
Click here to review
previous Ear, Nose and Throat Clinic consultations