Ear Symptoms

Medically Reviewed By William C. Lloyd III, MD, FACS
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What are the signs of ear problems?

Your ear is divided into three sections: the outer ear (including the external ear and ear canal), the middle ear (including the eardrum, three tiny bones called ossicles, and the eustachian tube), and the inner ear. The eustachian tubes are responsible for equalizing air pressure in the middle ear and allowing fluid to drain from the middle ear to the throat. A variety of mild to serious diseases, disorders and conditions can lead to ear symptoms affecting different areas or structures of the ear.

Types of ear symptoms

Ear symptoms vary depending on the underlying disease, disorder or condition. Typical ear symptoms include:

  • Burning sensation in the ear
  • Drainage of pus and blood from the ear canal followed by pain relief, which indicates that the eardrum has ruptured
  • Ear pain or discomfort
  • Foul-smelling discharge
  • Hearing loss
  • Hearing unusual sounds such as ringing
  • Itching in the ear
  • Low-set ears (caused by genetic disorders, such as Down syndrome and Turner’s syndrome)
  • Spot, sore or growth on the skin of the outer ear or ear canal
  • Tugging or rubbing at the ear in infants and young children

Depending on the cause, ear symptoms can begin suddenly and disappear quickly, such as an earache due to a change in altitude. Ear symptoms can develop over time and occur along with additional symptoms that may be a sign of a more serious condition, such as hearing loss or rarely, a tumor. Ear symptoms may occur in both ears or only in one ear or a small part of the ear.

The most common cause of ear symptoms in children is a middle ear infection (otitis media). In adults, ear symptoms can result from infection, inflammation, trauma, malignancy (skin cancer), other abnormal processes, and aging. Underlying conditions in another region of the body can lead to secondary or referred ear symptoms, such as disorders of the jaw joint (temporomandibular joint) and teeth.

Certain types of ear symptoms can indicate a serious medical condition, such as a serious infection, encephalitis, or malignant tumors, which can lead to loss of hearing and other complications. Seek prompt medical care for undiagnosed or unexplained ear symptoms or if your ear symptoms get progressively worse or do not improve within 24 to 48 hours after treatment for the underlying cause. Seek immediate medical care (call 911) if you, your child, or someone you are with, have ear symptoms after a head injury or ear symptoms along with excessive crying, dizziness, change in alertness, ear swelling, seizures, lethargy, or facial weakness.

What other symptoms might occur with ear symptoms?

Ear symptoms may be accompanied by other symptoms, which vary depending on the underlying disease, disorder or condition. For example, a middle ear infection (otitis media) can cause ear pain accompanied by chills and fever and irritability in infants and children. Ear pain on one side accompanied by popping or clicking sounds while chewing or yawning might indicate that you have referred pain from your jaw due to temporomandibular joint disorder (often called TMJ).

Adults and children

Symptoms that can occur with ear symptoms in both adults and children include:

  • Difficulty or pain with swallowing
  • Ear lesions or sores
  • Jaw pain
  • Neck pain
  • Pain behind the ear
  • Popping or clicking sound while chewing or yawning
  • Redness and warmth of the ear and surrounding tissue
  • Swollen tonsils
  • Tooth pain

    Infants and young children

    Infants and children commonly contract infections of the middle ear, called otitis media. Children with ear infections often tug or rub at their ears. It is important to know additional symptoms that may occur with otitis media and other ear problems, since many infants and children cannot clearly communicate to you where they feel pain or other symptoms. The following symptoms may be observed with infants and children who are experiencing ear symptoms:

    • Fussiness

    • Inattentiveness

    • Irritability

    • Misunderstanding what people say

    • Poor feeding

    • Wanting the television, radio or computer volume turned up louder than normal

    Symptoms that might indicate a serious or life-threatening condition

    In some cases, ear symptoms may occur with other symptoms or certain combinations of symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, your child, or someone you are with, have any of the following symptoms:

    • Blood draining from the ear, especially after a head injury

    • Change in alertness or consciousness

    • Change in mental status such as confusion

    • Crying inconsolably or intense distress

    • Dizziness or feeling of vertigo

    • Facial weakness

    • Seizure

    • Sudden hearing loss

    • Sudden, severe headache or worst headache of your life

    What causes ear symptoms?

    In children, ear symptoms are most frequently due to ear infections, but they can also be caused by irritating substances in the ear and other conditions. In adults, ear symptoms are often due to disorders and conditions originating in the ear, but can also be due to conditions in areas outside the ear. This is due to the variety of nerves and connective tissues that are shared by other head and neck structures. For example, ear pain when swallowing can be caused by a blocked eustachian tube, sore throat, or sinusitis. In some cases, ear symptoms can be indicative of a serious infection or other condition that should be evaluated as soon as possible or in an emergency setting.

    Ear infections that cause ear symptoms

    Ear symptoms are caused by different types of infections that originate in the ear including:

    • Blocked eustachian tube, which is itself often caused by a cold

    • Ear cellulitis (skin infection)

    • Eardrum infection (myringitis)

    • External (outer) ear and ear canal infection (otitis externa, often called swimmer’s ear)

    • Mastoiditis (infection of the bone behind the ear that is often caused by spread of a middle ear infection)

    • Middle ear infection (otitis media)

    Infections not specific to the ear that can cause ear symptoms

    Ear symptoms can also be caused by infections that originate in parts of the body outside the ear including:

    • Chickenpox, measles and mumps

    • Encephalitis and meningitis

    • Influenza (flu)

    • Intrauterine infections including cytomegalovirus, German measles (rubella) and herpes (causing hearing loss in the fetus)

    • Laryngitis (infection or inflammation of the voice box)

    • Ramsay Hunt’s syndrome (varicella-zoster virus infection of the facial nerve, also called shingles and herpes zoster oticus)

    • Sinusitis (from infection or inflammation)

    • Tonsillitis or peritonsillar abscess

    • Tooth infection or abscess

    Noninfectious diseases and conditions originating outside of the ear

    Ear symptoms can be caused by noninfectious disorders, diseases and conditions including:

    • Enlarged lymph node

    • Infant teething

    • Recent tonsillectomy (removal of tonsils)

    • Sore throat

    • Teeth clenching or grinding (bruxism)

    • Temporomandibular joint disorder (also called TMJ)

    • Trigeminal neuralgia (chronic pain from malfunction of the nerve responsible for facial sensation)

    Malignant and benign tumors that cause ear symptoms

    Rarely, ear symptoms can be caused by different types of tumors, some of which are benign, and some that are caused by cancer. They include:

    • Cancer of the head or neck
    • Glomus tumor (benign middle ear tumor)
    • Squamous cell tumor (malignant tumor in the middle ear and mastoid)

      Physical or traumatic causes of ear symptoms

      Ear symptoms can be caused by different kinds of physical or environmental factors or injuries including:

      • Buildup of fluid (seen mainly in children, also called serous otitis)

      • Buildup of wax in the ear canal (seen mainly in children, also called ceruminosis)

      • Ear trauma or other injury

      • Exposure to very loud noises

      • Foreign body, such as a cotton-tipped swab or other small object

      • High altitudes or other pressure changes (barotrauma)

      • Irritating substances such as shampoo

      Other causes of ear symptoms

      Ear symptoms can be caused by other disorders and conditions including:

      • Autoimmune inner ear disease

      • Chromosomal disorders, such as Down syndrome and Turner’s syndrome, both of which cause low-set ears

      • Congenital hearing loss (hearing loss present at birth due to genetic factors)

      • Gestational diabetes (can cause hearing loss in the baby)

      • Ménière’s disease (disease of the inner ear)

      • Otosclerosis (disease of the middle ear)

      • Ototoxic drugs that damage the auditory system

      • Premature birth (can cause hearing loss in the baby)

      • Presbycusis (hearing loss occurring in later life)

      • Ruptured eardrum

      • Toxemia during pregnancy (can cause hearing loss in the baby)

      Questions for diagnosing the cause of ear symptoms

      To diagnose the underlying cause of ear symptoms, your doctor or licensed health care practitioner will ask you several questions related to your symptoms. Questions for diagnosing the cause of ear symptoms include:

      • Have you had any change in hearing or hearing loss?
      • Do you experience ringing or other noises? (tinnitus)
      • Do you have pain in one or both ears, and if so, when did it start?
      • What other symptoms do you have?

      What are the potential complications of ear symptoms?

      Complications associated with ear symptoms can be progressive and vary depending on the underlying cause. Because ear symptoms can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to contact your health care provider when you have persistent symptoms that you are concerned about. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications including:

      • Bell’s palsy
      • Chronic otitis media
      • Hearing loss (temporary or permanent)
      • Impaired speech and language development in children
      • Recurrent ear infections
      • Spread of infection to the base of the skull and other surrounding structures and tissues
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      Medical Reviewer: William C. Lloyd III, MD, FACS
      Last Review Date: 2021 Jan 10
      View All Ear, Nose and Throat Articles
      THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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