Pain may be caused by intrinsic otopathology or might be referred from a distant pathologic process. Even though the most common cause of otalgia is infection, anything from a foreign body to barotrauma to oropharyngeal tumors may cause this symptom. Your approach should focus on the diagnosis and treatment of acute processes while excluding serious pathology.
History Obtain a detailed history.
Inquire about symptoms of pain, discharge, hearing loss, vertigo, and pain in other areas such as the pharynx or larynx. Severe otalgia may radiate to the jaw or neck. Determine if there was a precedent upper respiratory infection before the onset of otalgia that might suggest an infectious process such as acute sinusitis or otitis media. This may indicate barotrauma complicated by oxygen otitis media. Constitutional symptoms may include fever, chills, positional vertigo, tinnitus, nausea and vomiting, sore throat, dental pain, headache, and cranial nerve palsies.