Ear Pain in Children: Common Causes and When to See an ENT Specialist
Ear Pain in Children: Common Causes and When to See an ENT Specialist
Ear pain is a common complaint in children. Sometimes it is caused by a simple ear infection, while in other cases the pain may be related to earwax, a foreign body, throat infection, or problems involving the nose and sinuses.
Because young children may not always be able to explain exactly what is bothering them, persistent or severe ear pain should not be ignored.
What Are the Common Causes of Ear Pain in Children?
Middle Ear Infection
A middle ear infection (otitis media) is one of the common causes of ear pain in children.
It can occur following a cold or upper respiratory infection. Children may develop:
Ear pain
Fever
Irritability
Difficulty sleeping
Reduced appetite
Pulling or rubbing the ear
Reduced hearing
Some children may also develop fluid behind the eardrum after an infection, which can temporarily affect hearing.
Earwax Build-Up
Earwax is normal and helps protect the ear.
However, excessive wax accumulation can sometimes cause:
Ear discomfort
A blocked sensation
Reduced hearing
Itching
Occasionally pain
Earwax should not be routinely removed using cotton buds or other objects.
Foreign Body in the Ear
Young children may accidentally put small objects into their ears.
A foreign body can cause:
Sudden ear pain
Discharge
Bleeding
Reduced hearing
Foul-smelling discharge
Parents should not attempt to remove a deep or firmly lodged object at home. An ENT specialist can examine the ear and remove it safely using appropriate instruments.
Outer Ear Infection
An infection of the ear canal, known as otitis externa, can cause significant pain.
Pain may become worse when the outer ear is touched or moved.
It may occur after swimming, excessive moisture in the ear canal, or trauma caused by inserting objects into the ear.
Throat Infection
Sometimes the source of ear pain is actually the throat.
Because the throat and ear share nerve pathways, conditions such as tonsillitis or throat infections can cause referred pain in the ear, even when the ear itself appears normal.
Nasal Blockage and Related Problems
Children with persistent nasal blockage, enlarged adenoids or recurrent upper respiratory infections can develop problems with pressure regulation in the middle ear.
This may contribute to:
Ear fullness
Reduced hearing
Recurrent ear infections
An ENT assessment may be helpful when ear symptoms occur repeatedly along with nasal problems.
Should Parents Use Ear Drops for Ear Pain?
Do not start ear drops without medical advice.
Different ear conditions require different treatments. Some ear drops may not be appropriate when there is a hole or perforation in the eardrum.
Using an inappropriate ear drop can potentially cause complications.
Therefore, parents should avoid buying and using ear drops on their own based only on the symptom of ear pain.
The correct treatment depends on the cause of the pain and the condition of the eardrum.
Should We Clean a Child’s Ear With Cotton Buds?
Generally, cotton buds should not be inserted into the ear canal.
They can:
Push earwax deeper
Scratch the ear canal
Cause bleeding
Injure the eardrum
Increase the risk of infection
The ear has its own natural mechanism for clearing wax.
If excessive wax is causing symptoms, an ENT specialist can assess the ear and recommend appropriate management.
When Should a Child With Ear Pain See an ENT Specialist?
An ENT consultation is particularly important when:
Ear pain is severe or persistent
Ear pain keeps recurring
There is discharge from the ear
There is bleeding
The child has reduced hearing
The child develops repeated ear infections
There is significant fever
The child has dizziness or balance problems
A foreign body may be present
The child has persistent nasal blockage or snoring
There is concern about hearing or speech development
What About Ear Pain With Fever?
Ear pain with fever can occur with infections, including middle ear infections.
However, fever does not by itself prove that the child has a bacterial ear infection.
The doctor may need to examine the ear using an otoscope to look at the ear canal and eardrum before deciding on treatment.
Antibiotics are not required for every episode of ear pain.