Uniformed Services University F Edward Hébert School of Medicine Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, MD 20814-4799.
FP Essent. 2021 Feb;501:30-37.
Ear pain (otalgia) is a common reason for visits to family physician offices and emergency departments. Otalgia is primary when the pathology originates from the ear, and is secondary for disease processes associated with otalgia and an ear examination with normal findings. The most common diagnosis related to otalgia in children and adults is acute otitis media (AOM). It is characterized by an erythematous, bulging, and cloudy tympanic membrane. Otitis media with effusion is the presence of fluid behind the tympanic membrane without signs of inflammation. Chronic middle ear effusion is managed definitively with myringotomy and tympanostomy tube placement. Tympanic membrane rupture is a common complication after AOM or trauma. Tympanic membranes that do not heal develop chronic infection, leading to chronic suppurative otitis media. Initial management is cleaning and drying of the ear and application of topical antibiotics. Otitis externa is a painful cellulitis of the external auditory canal associated with erythema, edema, and occasional drainage. Cerumen impaction is managed with cerumenolytics, irrigation, or manual extraction. Foreign bodies in the ear are common in children younger than 6 years. Many foreign bodies can be removed with irrigation or forceps.
耳痛（耳痛）是家庭医生办公室和急诊科就诊的常见原因。耳痛原发于耳部时为原发性，与耳痛相关的疾病过程和正常耳检查结果相关时为继发性。与儿童和成人耳痛最相关的诊断是急性中耳炎（AOM）。其特征为鼓膜红斑、隆起和混浊。鼓室积液是指鼓膜后存在液体而无炎症迹象。慢性中耳积液通过鼓膜切开术和鼓室造口管放置来明确治疗。鼓膜破裂是 AOM 或外伤后的常见并发症。未愈合的鼓膜会发展为慢性感染，导致慢性化脓性中耳炎。初始治疗是清洁和干燥耳朵，并局部应用抗生素。外耳炎是外耳道的疼痛性蜂窝织炎，伴有红斑、水肿和偶尔有分泌物。耵聍栓塞可用耵聍溶解剂、冲洗或手动取出。6 岁以下儿童的耳内异物很常见。许多异物可以通过冲洗或钳子取出。
