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).

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

• Difficulty or pain with swallowing

• Ear lesions or sores

• Facial pain

• Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches, and pains)

• General ill feeling (malaise)

• 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 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

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

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 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)

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

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)

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:

• Acoustic neuroma (benign brain tumor)

• Basal cell tumor (skin cancer on the outer ear)

• Cancer of the head or neck

• Cholesteatoma, cholesterol granuloma (noncancerous cystic masses)

• Glomus tumor (benign middle ear tumor)

• Squamous cell tumor (malignant tumor in the middle ear and mastoid)

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

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)

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:

• Has there been discharge or bleeding from the ear?

• 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?

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

• Brain abscess

• Chronic otitis media

• Hearing loss (temporary or permanent)

• Impaired speech and language development in children

• Meningitis (infection or inflammation of the sac around the brain and spinal cord)

• Recurrent ear infections

• Spread of cancer

• Spread of infection to the base of the skull and other surrounding structures and tissues