Pain which may originate in the ear itself, or elsewhere in the head and body. In children earache with fever is usually caused by inflammation of the middle ear (otitis media). Pus in the middle ear causes a slight decline in hearing. Another common source of earache is inflammation of the ear canal (otitis externa); this may involve the whole canal, or may be local (a boil, for example). The condition is often caused by poking with sharp objects; a characteristic symptom is pain caused by pressure on the ear canal or pulling the ear. The eardrum can also become inflamed, often associated with a cold, and also causing severe pain, but without impairment of hearing. Finally earache can result from reduced pressure in the middle ear. If the Eustachian tube is closed by swollen mucous membrane when the patient has a cold, or by abrupt pressure changes when flying, pressure drops sharply, causing pain (barotrauma). Pain does not always originate in the ear itself; it can be caused by severe tooth decay or abscesses, or inflammation or tumours of the tongue, tonsils, salivary glands or lower jaw.

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