To the reference book Ear pain or otalgia is a symptom that can manifest itself in various diseases. Self-medication is unacceptable, since there is a high risk of intracranial complications (meningitis, sepsis, labyrinthitis), and persistent hearing loss, even loss, is possible.
Ear pain or otalgia is a symptom that can occur with various diseases. The ear and parotid region are a very sensitive reflexogenic area and are innervated by several large nerves. The branches of the trigeminal nerve, vagus, and cervical plexus nerves are involved in providing ear sensitivity, so inflammatory processes in the ear, neck, and maxillofacial area can be accompanied by pain. Also, ear pain is quite common with dental problems, osteochondrosis of the cervical spine, inflammation of the lymph nodes and tonsils, and neurogenic problems.
Painful sensations in the ears are a serious concern and significantly impair the quality of life, so they cannot be ignored. Self-medication is unacceptable, since there is a high risk of intracranial complications (meningitis, sepsis, labyrinthitis), and persistent hearing loss, even loss, is possible. Contacting an otolaryngologist is a guarantee of a quick return to normal health and no risk of complications.
Features of the pathology
The ganglion of the ear is a complex structure formed by autonomic and sensory nerve fibers. This nerve node performs the following functions:
- responsible for the sensitivity of the temporomandibular joint;
- responsible for the functioning of the salivary gland;
- regulates the sensitivity of the external auditory canal.
This node or ganglion is responsible for the sensitivity of the area, so when it is damaged, pain is felt. With neuralgia of the ear, patients note the following symptoms:
- shooting and sharp pain in the ear;
- excessive salivation;
- feeling of stuffiness in the ear.
Pain is often reflected into the lower jaw, which makes it difficult to make a diagnosis and determine the cause of the pain syndrome.
To make a diagnosis, consultation with three specialists is necessary - an otolaryngologist, a neurologist and a dentist, since the symptoms of neuralgia largely repeat the symptoms of otitis media and some dental diseases.
Neuralgia of the ear ganglion
Auricular ganglion neuralgia
is a disease of the auricular autonomic ganglion, manifested by paroxysms of vegetalgia involving the parotid region and ear. During an attack, pain can radiate to the back of the head, lower jaw, neck, shoulder girdle, arm and upper chest. Paroxysm is accompanied by hypersalivation, sometimes by clicks in the ear and congestion.
Hearing is not impaired. Diagnosis is carried out by a neurologist, but includes consultation with an otolaryngologist, dentist and other specialists depending on the clinical situation. The treatment plan consists of drugs for the relief of painful paroxysms, vascular, decongestant, metabolic drugs, physiotherapeutic procedures and reflexology.
The important point is to eliminate the root cause of neuralgia.
The auricular autonomic ganglion is a collection of interneurons of the sympathetic and parasympathetic nerve pathways.
The node receives sympathetic preganglionic fibers through the plexus of the middle meningeal artery, and parasympathetic fibers from a branch of the glossopharyngeal nerve.
Postganglionic fibers of the auricular ganglion are part of the auriculotemporal nerve, which is a branch of the trigeminal nerve. They go to the ear gland and vessels of the temporal region, providing their autonomic innervation.
Neuralgia of the ear ganglion is included in the group of vegetative ganglionitis of the head, which also includes neuralgia of the submandibular and sublingual ganglion, ganglionitis of the ciliary ganglion, ganglionitis of the pterygopalatine ganglion and the upper cervical sympathetic ganglion, cervical truncitis. Specialists in the field of neurology have collected statistical data indicating that neuralgia of the ear ganglion is most common in middle-aged and young women.
Neuralgia of the ear ganglion
Etiopathogenetically, neuralgia of the ear node is an irritative disease that develops reflexively in the presence of pathological autonomic impulses coming from chronic infectious foci or chronic processes in somatic organs.
The most important pathology is one that is localized in the same region as the ear node and is infectious and inflammatory in nature.
These include diseases of the parotid gland (mumps, sialadenitis, stones), chronic purulent otitis, chronic tonsillitis, sinusitis (frontal sinusitis, sinusitis, ethmoiditis), dental diseases (chronic periodontitis, stomatitis, gingivitis, periodontitis).
Less common is neuralgia of the ear node, caused by the presence of a distant source of infection (pyelonephritis, urethritis, cystitis), a general infectious process (tuberculosis, syphilis, chronic sepsis), metabolic disorders due to endocrine pathology (hyperthyroidism, diabetes mellitus) or somatic disease (cirrhosis of the liver). , cholecystitis, chronic renal failure, chronic gastritis, gastroduodenitis, adnexitis).
Neuralgia of the ear ganglion is manifested by attacks of vegetalgia that occur in front of the opening of the external auditory canal, in the parotid region and in the ear on the affected side. Intense burning or throbbing pain radiates to the lower jaw, behind the ear, to the back of the head, neck and shoulder girdle of the corresponding side.
The reflex mechanism of pain irradiation leads to its spread to the upper chest and arm. Painful paroxysms can be provoked by ingestion of hot food or drinks, hypothermia of the face, psycho-emotional stress, and excessive physical activity.
The duration of an attack of vegetalgia, as a rule, is several minutes, but can be an hour or more.
The dependence of the functioning of the autonomic nervous system on external factors (lighting, barometric pressure, temperature changes, air humidity, etc.) determines the characteristic rhythm of vegetalgia - its occurrence mainly in the evening and at night, exacerbation in the autumn and spring.
In some cases of neuralgia, a paroxysm of pain is accompanied by ear congestion or a sensation of clicking in it. The latter is caused by periodic reflex spasms of the muscles of the auditory tube. Often during an attack, patients note a noticeable increase in salivation, while in the interictal period hypersalivation is not observed. Hearing function is not affected.
Patients often turn to a dentist or otolaryngologist for help, and are then referred to a neurologist for consultation.
The latter makes a diagnosis based on typical complaints, the presence of sharp pain on palpation of the sclerotomal points of the auriculotemporal, mental and mandibular nerves, Richet's point - the place where the ear ganglion anastomoses with the mandibular nerve.
The detection of hyperalgesia in the parotid region also speaks in favor of neuralgia. In a difficult diagnostic situation, they resort to diagnostic novocaine or lidocaine blockade of the ear ganglion.
In the diagnostic process, determining the etiology of neuralgia plays an important role.
For this purpose, a dental examination and ultrasound of the parotid salivary gland, an otolaryngological examination (audiometry, otoscopy, rhinoscopy, pharyngoscopy, radiography of the paranasal sinuses) are performed.
If necessary, consultations with specialized specialists (urologist, gastroenterologist, gynecologist, endocrinologist, etc.) and additional studies of somatic organs (gastroscopy, ultrasound of the abdominal cavity, ultrasound of the kidneys, study of thyroid hormone levels, etc.) are prescribed.
Differential diagnosis includes otitis media, eustachitis, trigeminal neuralgia, mumps, tumors, cysts and stones of the parotid gland.
Emergency care aimed at relieving paroxysms of vegetalgia includes the use of anti-inflammatory and analgesic drugs: metamizole sodium, acetylsalicylic acid, aminophenazone, therapeutic novocaine blockades.
They are combined with ganglion blockers (benzohexonium, pachycarpine), antispasmodics (drotaverine, ganglefen), sedatives (motherwort, valerian, bromine preparations) and hypnotics (phenobarbital, barbamyl, zopiclone).
An additional analgesic effect is provided by electrophoresis with novocaine or ultraphonophoresis with hydrocortisone on the area of the ear node.
Metabolic and vascular therapy is indicated: vitamins gr. B, pentoxifylline, nicotinic acid. To reduce swelling, antiallergic drugs (promethazine, chloropyramine, loratadine, desloratadine) are used. If signs of irritation of parasympathetic fibers predominate in the neuralgia clinic, anticholinergic drugs are prescribed: platiphylline, diphenyltropin, etc.
Intolerance to pharmacotherapeutic treatments is an indication for reflexology using acupuncture, magnetic puncture, and laser puncture methods. During the period of convalescence, DDT, amplipulse therapy, and electrophoresis with hyaluronidase are recommended.
Of fundamental importance in treatment is the elimination of the root cause of the disease: sanitation of the oral cavity, treatment of otolaryngological diseases and oral pathology, correction of endocrine disorders, therapy of chronic diseases of somatic organs. According to indications, surgical interventions are performed: removal of tumors and stones of the parotid gland, dissection of adhesions, sanitizing surgery on the middle ear, ethmoidotomy, maxillary sinusotomy, frontotomy, etc.
Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_neurology/ear-neuralgia
Causes
More often, neuralgia of the ear node develops due to the presence of a source of infection in the body. The infection spreads throughout the body through the bloodstream and enters the area of the cranial nerves, causing an inflammatory process. The reason may be:
- inflammation of the salivary gland;
- blockage of the salivary glands;
- chronic and purulent inflammation of the middle ear (otitis);
- tonsillitis, including chronic ones;
- sinusitis;
- bacterial and infectious dental diseases.
In some cases, secondary inflammation of the ear nerve is observed. This is typical for diseases such as pneumonia, sepsis and kidney pathologies. Damage to the auricular ganglion may be one of the manifestations of diabetic polyneuropathy.
Symptoms of acoustic neuritis
The first sign of auditory neuritis is hearing loss or noise in the ear. In this case, the decrease occurs in varying degrees of intensity, up to complete deafness, which occurs within a few hours. In addition to hearing loss, patients note:
- noise in ears;
- ringing in the ear that you want to get rid of;
- disorders of the vestibular system - balance disorder, dizziness with nausea and sometimes vomiting.
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health. Phone for appointment +7 (495) 292-39-72
Causes of acoustic neuritis
There are many factors that can lead to an inflammatory reaction in the auditory nerve. These include:
- Infections. Acoustic neuritis often develops as complications after influenza, mumps, rubella, scarlet fever, meningitis, etc.
- Head injuries (including barotrauma).
- Poisoning with toxic substances (mercury, lead, gasoline, phosphorus, arsenic, agricultural poisons, medicines, alcohol).
- The effect of noise and vibration at pathological frequencies.
- Metabolic disorders.
- Endocrine disorders.
- Diseases of the cardiovascular system.
- Tumors.
- Osteochondrosis of the cervical spine
- Hypertonic disease
Diagnosis of acoustic neuritis at SM-Clinic
All ENT doctors at the SM-Clinic in Moscow have extensive experience, allowing them to make an accurate and timely diagnosis and determine treatment options. At the beginning of the appointment, the doctor will fully interview the patient about the symptoms, find out the frequency, nature and intensity of their manifestations.
Then, the specialist will conduct audiometry. This study is carried out using a special electroacoustic device - an audiometer. Using this diagnostic technique, the doctor will measure hearing sensitivity, hearing acuity, and examine air and bone conduction. Audiometry is absolutely painless and does not take much time.
To conduct the study, the patient is in a specially equipped soundproof room. He puts on headphones and is given sound signals of various frequencies. The patient needs to press the button after he hears the signal. In young children, audiometry is performed automatically using a computer. During sleep, special electrodes are placed on the head, which read brain signals in response to stimuli.
Treatment of acoustic neuritis at SM-Clinic
Our center’s ENT doctors take a comprehensive approach to treating each person, using consultations with related specialists if necessary. The main thing for us is to determine how to treat the patient as quickly and efficiently as possible.
It is very difficult to restore auditory nerve tissue, so it is very important to seek treatment from a doctor at the first symptoms. If the nature of the neuritis is infectious, then the doctor’s initial task is to prescribe antibacterial drugs. In addition, drugs are prescribed to improve tissue metabolism, blood circulation and nerve impulse conduction:
- vitamins;
- immunomodulators;
- aloe preparations;
- biostimulants;
- angioprotectors;
- microcirculation correctors.
If toxins enter the body, detoxification therapy is used. Diuretics, diaphoretics, and antihistamines are prescribed.
Our doctors obtain good results when treating acoustic neuritis with the help of physiotherapy, acupuncture, magnetic therapy, and hyperbaric oxygenation. Acoustic neuritis involves repeating treatment courses 1-2 times a year. This allows you to stop damage to the auditory nerve and prevent complete deafness.
Symptoms of the disease
Pain with neuralgia of the ear can radiate to the jaw, but more often patients notice pain in the ear and around the auricle, spreading to the temporal region.
The pain is paroxysmal, with a tendency to intensify under certain influences. A factor that provokes increased pain during neuralgia is the consumption of hot food.
Often the pain intensifies and becomes acute with strong psycho-emotional stress or stress. Attacks of pain are short-lived and can vary from a few minutes to one hour.
The eardrum is very susceptible to vibrations, so even a sudden change in atmospheric pressure can trigger a new attack of pain. Particularly often there is an increase in pain in humid weather.
Neuralgia of the ear node is considered a seasonal disease, since in most cases the problem becomes relevant in the fall and spring, when there is predominantly rainy weather and low air temperatures.
Nerve endings in the ears
It has long been established that the ears are not an ordinary organ that allows them to capture sound waves, but for knowledgeable people it is also an indicator of a healthy body.
Due to its appearance, the shell of the ear resembles a human embryo, based on which it is possible to determine the active zones on the ears that are responsible for any organ. For example, the main points of the head are located on the lobe, and the condition of the chest can be determined by the bowl of the auricle and treated.
Important. In this situation, if the internal organs are not in order, then such phenomena are indicated by the appearance of stripes, spots, scars or tubercles in the appropriate places.
The points on the human body are located very unevenly. Their greatest concentration is on the ears , where there are more than 117 of . It is noteworthy that the human body no longer has such a density of reflex zones.
The invaluable importance of the active points of the ear, which are located on the cartilage, near the ear canal, is determined by their effect on the following organs :
- heart;
- kidneys;
- pancreas;
- lungs;
- liver;
- intestines;
- spleen.
Massaging the points on the sink can also help treat the musculoskeletal system. The main zone where active points are located is located in the upper part of the ear, where there are cartilaginous protrusions and curls. In this case they are responsible for :
- Vertebrae of the neck and lower back.
- Small of the back.
- Elbows.
- Knees.
- Hands.
It is worth noting that in the case of paired organs, it is necessary to apply the rule of correspondence of sides , that is, when treating the right kidney, one should influence the points of the right ear and, accordingly, for the left kidney.
Location of biologically active points on the ear, responsible for various organ systems
Establishing diagnosis
To make a diagnosis, you must undergo the following examinations:
- Brain MRI;
- ultrasound examination of the salivary glands passing near the ear;
- examination by an otolaryngologist;
- dental examination.
Making a diagnosis is the task of a neurologist. The doctor will analyze the patient’s complaints and refer him to another specialist to rule out other pathologies with similar symptoms.
How to distinguish from otitis media
Neuralgia of the ear node is often mistaken for otitis media. To avoid this, you need to know the symptoms of middle ear inflammation:
- increased body temperature;
- fever and general weakness;
- pain when trying to open your mouth wide;
- discharge of pus from the ear canal;
With otitis, there is a prolonged aching pain with high fever. The ear stops hurting after a breakthrough, when pus begins to be released.
With neuralgia, the temperature does not rise. There is no fever or general weakness, but the pain is acute and appears periodically. Discomfort increases when eating hot food, and not when opening the mouth, which is typical for inflammation of the middle ear.
Can ears hurt with neurosis?
Auricular neuralgia is characterized by the development of burning pain in the ear area, which is why patients often confuse the neurological disease with otitis media.
A blurred clinical picture leads to an incorrect diagnosis. As a result, the duration of treatment increases and the pathology begins to progress. In such a situation, complications may arise that will lead to a deterioration in the patient’s general condition.
In this article we will talk about the causes, symptoms, diagnosis and treatment of neuralgia of the auricular nerve (node).
What it is?
Ear ganglion neuralgia is irritation of the nerve roots of the ear ganglion , which is formed from autonomic and sensory neurons.
This system is responsible for the proper functioning of the salivary glands and regulates the sensitivity of the ear canal.
In addition, the ear ganglion is responsible for the sensitivity of the skin between the temple and lower jaw. Therefore, when it is damaged, sharp pain, increased salivation and ear congestion occur.
The pathological process goes by several names: ganglionitis of the nerve ganglion or neuralgia of the ear . The auricular node belongs to the mandibular branch of the trigeminal nerve, so if it is damaged, there is a risk of developing trigeminal neuralgia.
Etiology
Neuralgia of the ear node often develops due to an infectious-inflammatory process in the body. Pathogenic microorganisms spread throughout the body along with circulating blood, so they easily enter the area of the central nervous system.
Infection of the cranial nerves leads to irritation of the small roots that form the ear ganglion. As a result, the nerve fibers swell and begin to hurt greatly.
Other reasons for the development of the disease are:
- inflammatory process in the salivary gland;
- acute or chronic tonsillitis;
- blockage of the salivary gland ducts;
- purulent-inflammatory disease of the ear - otitis media;
- sinusitis;
- Dental pathologies are bacterial infections.
In rare cases, secondary inflammation of the ear nerve develops . This situation is typical for systemic diseases: pneumonia, pathologies of the genitourinary system, sepsis. In this case, neuralgia occurs as a symptom and indicates the development of another disease.
In patients with diabetes mellitus, damage to the ear node may develop against the background of diabetic polyneuropathy.
Risk factors
The risk of developing neuralgia increases in the following cases:
- in elderly patients;
- against the background of mental disorders;
- hypo- and avitaminosis of vitamins B;
- chronic stress, fatigue;
- prolonged hypothermia;
- metabolic disorders: diabetes mellitus, thyroid disease, endocrine diseases, gout;
- the presence of worms;
- prolonged fasting, anorexia, bulimia;
- gastrointestinal pathologies characterized by impaired absorption of nutritional components;
- chronic sinusitis;
- purulent-inflammatory formations in the oral cavity: phlegmon, abscesses, pulpitis, gingivitis;
- osteomyelitis of the skull bones;
- infectious pathologies accompanied by intoxication of the body: botulism, tuberculosis, syphilis;
- autoimmune diseases;
- severe allergic reactions.
Clinical picture: symptoms and manifestations
Neuralgia of the ear node manifests itself in the form of acute pain, which can radiate to the lower jaw . Pain around the ear is often noted.
In such a situation, discomfort is felt throughout the entire temporal region. Swelling of the lymph nodes behind the ear appears with the development of an infectious process.
The pain intensifies during movement or when exposed to certain factors : temperature changes, eating hot or cold food. Also, the intensity of the symptom increases during emotional shock or stress.
Violation of the psychological state leads to the appearance of short-term tingling sensations. Depending on the level of stress, painful colic in the ear can last from 3-4 minutes to 1 hour.
The largest number of sensory neurons is concentrated on the eardrum. The thin tissue is in constant motion while picking up sound vibrations, which leads to the development of constant pain.
The syndrome worsens in humid weather when changes in atmospheric pressure occur. The air begins to put pressure on the membrane, which leads to an increase in the intensity of the pain symptom.
Attacks appear suddenly; ear congestion warns of their approach . The pain periodically intensifies and subsides. During an attack, saliva production increases, especially when hearing loud noise.
The attacks stop abruptly, along with a feeling of congestion in the ear canal and excessive salivation.
Possible patient complaints
Patients complain of paroxysmal burning pain , which is felt in front of the external auditory canal.
Depending on the individual structure of the nervous system, pain can radiate to the chin, lower jaw area, and teeth . In addition to the irradiation of pain, the patient feels that the ear is blocked and more saliva begins to be released.
An attack can be triggered by a draft, chewing movements, or touching the area between the temporomandibular joint and the external auditory canal. The last sensation is characteristic of neuralgia that develops against the background of an inflammatory process: sore throat, sinusitis, pulpitis.
How is diagnosis done?
When an ear or tooth begins to hurt, the patient seeks help from an ENT doctor or dentist . If the initial examination is unsuccessful, the patient is referred to a neurologist if trigeminal neuralgia is suspected.
The doctor makes a diagnosis based on the patient’s complaints, physical examination and several instrumental studies.
Palpation
The neurologist makes a preliminary diagnosis using palpation. The doctor presses on the painful points and observes the patient's reaction.
The specialist checks for pain when examining the scleromotor points for:
- chin;
- ear-temporal;
- mandibular nerve;
- Richet's point is the area where the ganglion joins the mandibular branch of the trigeminal nerve.
With neuralgia in these areas, when lightly touched or pressed, a sharp, severe pain is felt. With other ear diseases this problem does not arise.
In a difficult situation against the background of several infectious processes, differential diagnosis is supplemented with blockade of the ear ganglion . The procedure is performed using injections of painkillers: Novocaine and Lidocaine.
Treatment methods
The basis of therapy is analgesics and anti-inflammatory drugs. To reduce pain, taking painkillers with analgin or ibuprofen is recommended.
To relieve inflammation, medications containing diclofenac or ibuprofen are used. These nonsteroidal anti-inflammatory drugs also help relieve pain.
It is important to take antispasmodic drugs. This helps relieve muscle spasm of the auditory tube, which accompanies neuralgia and increases discomfort. Taking such drugs helps to quickly improve the patient's well-being.
To improve the patient's well-being and speed up recovery, taking sedatives is indicated. They help normalize sleep and strengthen the nervous system, which reduces the frequency of pain attacks and speeds up recovery.
Therapy is supplemented with B vitamins to improve the restoration of nerve fibers. Vasodilators, for example, with nicotinic acid, are often prescribed to improve local blood circulation and relieve spasm.
If for any reason drug treatment is not possible, physiotherapy is used - acupuncture, amplipulse, electrophoresis. This helps reduce pressure on the nerve, improve local metabolic processes and relieve the inflammatory process.
Blockade for neuralgia
Drug blockades are a method of long-term pain relief based on the injection of medication directly into the area of the affected nerve. For neuralgia of the auricular nerve, this method is one of the methods for making a diagnosis, since in case of otitis media, administering medication to the area of the nerve does not relieve pain.
Novocaine is usually used for pain relief. This helps relieve pain for several days. The blockade is used when the pain syndrome cannot be relieved with analgesics in tablets. The blockade does not replace therapy with anti-inflammatory drugs.
What to remember
For neuralgia of the ear, traditional methods of treatment based on exposure to heat cannot be used. Warming up in this case can provoke the spread of the inflammatory process.
If ear pain suddenly appears, and there are no symptoms of a cold or general malaise, you should first consult a neurologist. If discomfort is accompanied by an increase in temperature, you need to be examined by an otolaryngologist.
Often neuralgia of the ear becomes a constant companion for the patient. Due to the fact that the pain goes away on its own and the attacks do not last long, patients prefer not to pay attention to the discomfort. This approach is incorrect, since any disease should be treated in a timely manner.
