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Otalgia is one of the most common complaints that a physician caring for children encounter. Visualization and thorough cleaning of the ear canal is essential and referral to an otolaryngologist for binocular microscopic cleaning may be necessary. In assessing the painful ear, relevant history includes site, quality, and timing of pain; radiation of pain to other sites; aggravating or relieving factors.
Evaluation include a thorough history of the ear pain with an examination of the head and neck. On occasion, radiologic studies are indicated.
When the ear exam is unrevealing, distant sources of ear pain must be searched for on physical examination. Ear pain can be referred from distant sites in the head and neck secondary to inflammatory processes, tumors, or mechanical disturbances. These can all mimic primary ear disease. Pain is referred from these distant sites through the nervous system.
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