Ear Problems and Injuries, Age 12 and Older

Topic Overview

Ear problems may be caused by many different health problems. In children, ear pain is more likely to be a symptom of an inflammation, infection, or fluid buildup in the external or middle ear. But ear pain at any age may be a symptom of:

• Infection of the middle ear (acute otitis media).
• Inflammation or infection of the ear canal (otitis externa).
• Buildup of fluid behind the eardrum (otitis media with effusion), without infection.

Ear problems caused by an injury to the ear can occur at any age. Common injuries include the following:

• A fall or a forceful, direct blow to the side of the head can burst the eardrum or damage the tiny bones in the inner ear that send sound to the brain.
• Loud noises or explosions can damage the eardrum (acoustic trauma).
• Atmospheric pressure changes (barotrauma) can cause problems with the eustachian tube and trap air in or keep air out of the middle ear. Middle ear problems can be severe (for example, the ear drum can burst or the middle ear can fill with blood or pus) or mild and only be felt as changes in pressure.
• Cuts or scrapes may injure the outside of the ear or ear canal. For more information, see the topic Ear Canal Problems (Swimmer's Ear).
• Cleaning the ear canal too often, too forcefully, or with a cotton swab, bobby pin, or sharp fingernail can cause irritation or injury.
• Burns or frostbite can cause ear injuries (thermal injuries).
• Objects placed in the ear can cause injury to the ear canal or the ear drum (tympanic membrane).

Hearing loss often comes with age. As people get older, ear problems are more likely to be related to:

• Heredity. The age of onset and how quickly the hearing loss progresses can often be determined by studying family members with hearing loss.
• The buildup of earwax. For more information, see the topic Earwax.
• Exposure to loud noises, such as setting off an air bag during a car crash, machines at work, power tools, gunshots, or loud music.
• Other serious medical problems, such as Ménière's disease or an acoustic neuroma.
• Skin reaction (dermatitis) on the outside of the ear or in the ear canal from perfume, hair dye, or wearing hearing aids.

The ear shares nerves with other parts of the face, eyes, jaw, teeth, and upper neck. Pain that feels as if it is in the ear may be coming from another part of the head or neck. This is called referred ear pain and is more common in older adults. Causes of referred ear pain can include dental problems, jaw pain (temporomandibular disorder), or a sinus infection.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

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Author:	Jan Nissl, RN, BS	Last Updated: February 13, 2008
Medical Review:	H. Michael O'Connor, MD - Emergency Medicine William M. Green, MD - Emergency Medicine Kathleen Romito, MD - Family Medicine Donald R. Mintz, MD - Otolaryngology
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