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Prolonged inflammation leads to middle ear swelling, ulceration, perforation, and attempts at repair with granulation tissue and polyps. This can worsen discharge and inflammation, potentially developing into CSOM, often associated with cholesteatoma. Symptoms may include ear discharge or pus seen only on examination. Hearing loss is common.
Main symptoms of swimmer’s ear are a feeling of fullness in the ear, itchiness, redness, and swelling in or around the ear canal, muffled hearing, pain in the external ear and ear canal and especially a smelly discharge from the ear. [9] Constriction of the ear canal from bone growth (Surfer's ear) can trap debris leading to infection. [10]
The infection may be either subacute or acute and is characterized by itching in the ear, malodorous discharge, inflammation, pruritus, scaling, and severe discomfort or ear pain. The mycosis results in inflammation, superficial epithelial exfoliation , masses of debris containing hyphae , suppuration , and pain . [ 2 ]
The inner ear includes sensory organs for balance and hearing. When the inner ear is inflamed, vertigo is a common symptom. Other symptoms in adults include pain and drainage from ear or problems with hearing. [8] Symptoms in children can include excessive crying, touching at ears, drainage, and fever. [8]
There may be ear pain , and the ear or mastoid region may be red (erythematous). Fever or headaches may also be present. Infants usually show nonspecific symptoms, including anorexia, diarrhea, or irritability. Drainage from the ear occurs in more serious cases often manifests as brown discharge on the pillowcase upon waking. [4] [6]
First-line treatment options are generally aimed at treating the underlying cause and include attempting to "pop" the ears, usually via the Valsalva maneuver, the use of oral or topical decongestants, oral steroids, oral antihistamines, and topical nasal steroid sprays, such as Flonase.
If a patient presents to a doctor with ear discharge and hearing loss, the doctor should consider cholesteatoma until the disease is definitely excluded. [4] Other less common symptoms (all less than 15%) of cholesteatoma may include pain, balance disruption, tinnitus, earache, headaches and bleeding from the ear. [2]
Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt. Primary ear pain is more common in children, whereas secondary (referred) pain is more common in adults. [13] Primary ear pain is most commonly caused by infection or injury to one of the parts of the ear. [3]