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Stinging in the ear - causes, symptoms and therapy

Stinging in the ear - causes, symptoms and therapy


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Trigger and treatment for ear pricks

Stinging in the ear is mainly associated with colds and otitis media. In fact, there are various other ENT diseases that can trigger the stinging. In addition, special caution is advised if there are certain accompanying symptoms associated with ear pricking, because in some cases this indicates an onset of hearing loss.

Definition

Ear pricking is one of the so-called Otalgia. The term describes various forms of ear pain, whereby the signal stimuli of the following nerves are basically responsible for the development of pain:

  • Tongue-throat nerve (Nervus glossopharyngeus) - this nerve is also called IX. Known cranial nerve and usually responsible for sensory events in the middle ear
  • Tympanic nerve (Nervus tympanicus) - a branch of the IX. Cranial nerves, usually responsible for the taste sensation
  • Vagus nerve (Nervus vagus) - the X. cranial nerve is responsible not only for taste perception but also for sensations of touch and motor processes in the ear and throat area

Development of hearing

In order to understand how ear piercing occurs in detail, you first have to take a closer look at the structure of your hearing. Basically, the ear can be divided into five important main components. The Outer ear (Auris externa) forms the visible part of the ear, consisting of

- earlobes,
- auricle
- and external ear canal.

Piercing in the ear mainly occurs in the form of piercing earlobes. In this area of ​​the ear, insufficient blood circulation is usually responsible for this, for example due to the effects of cold or vascular diseases. If the circulatory disorder is particularly extensive, it can continue from the earlobe to the outer ear canal.

This is connected to the external auditory canal eardrum (Membrana tympani). It separates the outer ear from the inner ear canal and can also cause stinging ears. This mainly occurs due to injuries or inflammation of the thin membrane. And blockages in the ear canal, such as those caused by pent-up ear wax, can also cause eardrum stings.

The eardrum did not get its name for nothing. Because all the noises that get into the ear canal from the outside are heard by the membrane tympani as drumming vibrations Middle ear (Auris media) forwarded. In it there is the tympanic cavity, the ossicles consisting of

- hammer,
- anvil
- and stirrups,

process the noise vibrations. An inflammation of the middle ear, for example, can be painfully dangerous. It is one of the most common ear diseases associated with ear pricking.

The middle ear goes down into the Eustachian tube (also Eustachi tube, Latin Tuba auditiva Eustachii) about. On the one hand, the fine auditory canal serves to ventilate the tympanic cavity, which prevents the development of infections in the ear. On the other hand, the Eustachian tube, also known as the "ear trumpet", enables pressure equalization in the ears through body functions such as yawning, chewing and swallowing, thus relieving the pressure on the eardrum.

Unfortunately, the ear with the Eustachian tube is not only given opportunities for air exchange and pressure equalization. Since the ventilation channel is a direct connection between the ear and throat, pathogens from the ENT area can also easily migrate into the middle ear. Ear diseases that lead to stinging pain are favored in this way. In addition, the nerves along the ear canal often transmit pain stimuli from the throat area, which are then erroneously perceived as ear piercing.

Occasionally, the one behind the tympanic cavity can be found Inner ear (Auris interna) as a source of pain. In addition to the equilibrium organ, it also houses the cochlea, which is essential for sound transmission to the brain. Here, stinging often occurs together with balance disorders and headaches, for example in the context of an inner ear infection.

Colds as the main cause of ear pricking

Stinging ear pain occurs particularly often in autumn and winter. The wet and cold weather here often causes painful circulatory disorders in the outer ear. In addition, exposure to cold strains the immune system, which increases the risk of diseases such as runny nose (rhinitis), flu (influenza) and the common cold (also: flu infection). These have a known effect on all areas of the upper respiratory tract. Because of their proximity to the Eustachian tube, it is not uncommon for cold pain to radiate into the ear, where it can be felt as an ear prick.

If a cold or flu is not properly cured in the further course of the disease, there is also the risk that the responsible infectious agents will rise into the Eustachian tube. As a result, there is initially swelling and inflammation in the ventilation duct. The air exchange, as well as the pressure equalization in the ear, are made extremely difficult.

In addition to increased pressure conditions in the area of ​​the eardrum, such a ventilation disorder promotes the development of a tympanic effusion. Behind it is a collection of secretions in the middle ear, which can quickly develop into a focus of infection. If a subsequent infection occurs in this way, ear pricking is very likely. The usual accompanying symptoms are cough, hoarseness and runny nose, depending on the previous cold. Depending on the severity of the infection, fever and chills can also occur.

ENT diseases and stinging ears

Colds and flu are far from the only diseases in the ear, nose and throat area that can be the cause of a stinging sensation in the ear. In principle, diseases such as sore throat (pharyngitis), tonsillitis (tonsilitis) and sinusitis (sinusitis) can spread to the ear via the Eustachian tube.

Even diseases of the lower respiratory tract, such as pneumonia, have the potential to rise up to the ear via the neck and throat area. In the early stages of the diseases mentioned, it is often difficult to tell whether the symptoms of the disease only radiate to the ear or whether an infection has already spread into the ear.

Danger: Infectious diseases always carry the risk of blood poisoning! This is all the more likely if the infectious agents have already spread! Early treatment is therefore extremely important!

Particularly severe pain in ear infections

A typical follow-up infection in the event of infection spreading into the ear is otitis media. In this ear disease, stinging in the ear generally occurs at regular intervals and with particular intensity. Other accompanying symptoms may include difficulty swallowing, fever, dizziness and nausea. Purulent discharge from the ear is also possible if the eardrum is involved in the course of the disease and thus eardrum inflammation (myringitis).

If the otitis media remains untreated for a longer period of time, there is a risk of developing an otitis media (internal otitis or labyrinthitis). This generally not only increases the ear piercing, but also increases the risk of permanent hearing damage and even deafness of the affected ear.

Otitis media can not only arise from ENT diseases that rise into the ear. It is also conceivable that it was triggered from the outside of the eardrum. The most likely scenario in this connection is an external ear infection (otitis externa), which in itself can lead to ear pricking.

The disease is caused primarily by microbial contamination of the ear, such as bacteria, mites or fungal infections. The infectious agents mostly enter the ear canal through non-sterile foreign bodies such as cotton swabs or through water accumulations contaminated with germs.

In the latter case, staying in public baths is a classic route of infection. The bath water in the swimming pool here often contains contaminated dirt particles or urine residues that contribute to the infection. Therefore, if inflammation of the outer or middle ear is acquired during a bath, one speaks of the so-called swimmer otitis. In addition to colds, illness-related stinging in the ears in childhood mainly occurs in this way.

Speaking of water: water residues can also increase the ear pressure for a short time so that there is occasional stinging. However, the symptom is rather harmless and subsides as soon as the water has dissolved.

Piercing from injuries and increased pressure

Stinging ear pain is most dangerous if it is caused by hearing damage. As with inner ear infection, there is a permanent hearing loss, which is why it should always be examined by a doctor in connection with hearing problems.

Injuries to the ear can occur in a variety of ways. For example, damage to the noise-processing ear elements from inadequately treated ear infections is conceivable. Likewise, injuries to the eardrum, such as are possible in addition to advanced infections as well as extreme bang and explosion trauma or foreign bodies inserted into the ear, cannot be ruled out as the cause.

When it comes to injuries caused by increased pressure conditions, the intensity of the pressure increase is very important. Piercing ears due to diving at a moderate depth or increasing altitude pressure while flying are usually harmless. It is different with extreme pressure changes. The abnormal pressure behind the eardrum, which is caused by a lack of pressure equalization, can actually provoke painful injuries in the form of barotrauma.

Other causes of stinging ears

With a view to the causes of the illness for stinging ear pain, allergies and childhood diseases such as mumps, measles, scarlet fever or rubella must be mentioned as possible causes in addition to ENT diseases. Similar to the flu and the like, the causative agents of these infectious diseases can spread into the ears via the respiratory tract or bloodstream and further aggravate the stabbing pain caused by ear infections. This shows once again why the complete healing of infections is extremely important to avoid secondary infections.

Furthermore, various dental diseases should be mentioned with regard to radiation pain in the ear. Although they do not count as ENT diseases, they also occur in the catchment area of ​​the Eustachian tube and therefore like to send pain signals to the ear. Damage and inflammation of the tooth root and problematic wisdom teeth are known to cause earache as well as toothache. This can be explained on the basis of the tooth nerves, which are closely connected to the nerve strands responsible for otalgia.

Malformations of the hearing or jaw, skull fractures (e.g. a fracture of the base of the skull) and nerve inflammation cannot be excluded as a cause of pain either. Tissue changes such as pimples, eczema or boils in the ear are also conceivable, which are noticeable through stinging ear problems.

Occasionally, the complaints are due to a tumor in the ear. The accompanying symptoms are usually limited, which is why the stinging in the ears is often inexplicable at first.

Accompanying symptoms give first indications

As shown, the causes are very diverse. The appearance of otalgia is similar. A combination of pricking in the ears with various accompanying symptoms often gives a first indication of possible triggers:

Sounding ears:
The most harmless variant of ear pricking are "sounding ears", a sometimes sharp pain that arises from the cold in the outer ear or the earlobes. In such a case, this can be attributed to reduced blood flow to the ear's own blood vessels.

Tapping to pulsating ear pricking:
If the stinging occurs in combination with tapping or pulsing in the ears, this is usually a sign of severely constricted blood vessels. The vascular pressure is literally audible in such a case. In addition to the effects of cold, this form can also be based on an illness-related blood pressure disorder.

Stinging pressure pain:
There are many causes that lead to a change in ear pressure. Various scenarios are conceivable, from sudden differences in height, such as occur when flying by plane, to blocked ears, to a tympanic effusion and ventilation disorders of the Eustachian tube (e.g. in the case of inflammation-related swellings). Such pressure pains are not always dangerous. However, if symptoms persist, they should be clarified by a doctor to be on the safe side.

Stinging and difficulty swallowing:
Difficulty swallowing can also result from pressure changes in the hearing in the case of stinging ears. Otherwise, the accompanying complaint mainly occurs with colds, tonsillitis and throat infections. Other symptoms such as coughing or a rough throat are also conceivable in the course of the basic diseases mentioned, swallowing in particular generally causing a short-term intensification of the stinging pain.

This can be explained by the proximity of the throat area to the Eustachian tube and the involvement of swallowing in pressure equalization in the ear. In the worst case, the painful swallowing problems indicate that the ventilation duct is already affected by an illness-related infection. An inflammatory subsequent infection of the middle ear due to the rise of pathogens can then no longer be excluded.

Stinging ears and airway blockages:
In addition to difficulty swallowing, ear pricking in many ENT diseases also occurs together with a mucus throat, nasal congestion or a blocked frontal sinus. Corresponding accompanying symptoms are common except for colds and flu, especially for sinus and sinus infections. Recovered in time for these diseases is usually nothing to worry about. If left untreated, however, such diseases can spread far beyond the ear to the sensitive areas of the meninges and cause meningitis.

Stinging ears, headache and dizziness:
The inner ear represents the last station of perceived sounds before they enter the brain. In addition, the inner ear also houses the sense of balance. If this section of the ear is involved in the development of ear pricks, the symptom usually occurs together with relevant accompanying complaints such as dizziness, balance problems or headache. In addition, skull fractures and meningitis are noticeable due to perceptual disorders and headaches. In case of doubt, a doctor should therefore be consulted urgently with this combination of symptoms.

Stinging in the ears in combination with hearing problems:
In addition to the stinging sensation, a cold can also lead to hearing problems such as tinnitus. The cause can be both eardrum injuries from explosion and bang trauma, as well as extreme damage to other noise-processing ear elements, such as inner ear or middle ear infections. In any case, a combined occurrence of pricking and hearing problems should be examined by a doctor.

Stinging earache in combination with discharge:
Ear piercing is definitely a dangerous symptom if it occurs together with bloody or purulent discharge from the ears. Here, too, hearing injuries and advanced ear infections can be identified as the main causes. In the case of stinging ears in combination with liquid in the ear, quick treatment is urgently required in order to prevent permanent hearing damage.

Diagnosis

The medical diagnosis is usually made as part of a medical history. The questioning of the patient about existing accompanying symptoms and / or previous illnesses usually allows the doctor to suspect that the patient is right.

This is followed by a physical examination. In addition to throat, pharynx and nose tests as well as blood tests, ear examinations are primarily used here. For example, these can consist of comprehensive audiometry. Behind this is a series of standard hearing tests that test the hearing function based on various measured values. The Weber test, for example, is common, in which hearing is assessed using a tuning fork.

Otoscopies are also common. The hearing is illuminated with the light source of an otoscope in order to be able to discover existing hearing damage in the external auditory canal and on the eardrum. Imaging methods such as MRI, magnetic resonance imaging or ultrasound can also be used to assess the inner ear if there is concrete suspicion. This applies in particular if a skull fracture or an ear or jaw malformation is suspected behind the stabbing pain. A blood test, for example to diagnose infections, is also conceivable.

Therapy for piercing ears

Taking medication is not always necessary. However, the underlying infections are not to be trifled with, which is why it is better to use a suitable preparation too soon rather than too late. Numerous medicinal herbs, which relieve pain and reliably contain infectious agents thanks to their disinfectant properties, also offer good support during treatment. Below is an overview of possible treatment measures.

Medication

If infections are responsible for ear pricking, the use of antibiotic ear drops or tablets is inevitable. The risk is too great that infectious agents would otherwise get into the ear via the Eustachian tube. Common drugs include amoxicillin, azithromycin, clarithromycin and penicillin.

However, there are now also medicinal plant antibiotics such as Otovowen, which offer a good alternative in view of the increasing number of multi-resistant germs. For children in particular, such drugs are also gentler than aggressive antibiotics.

If the stinging is accompanied by pus in the ear or mucus in the respiratory tract, secretion-removing preparations such as acetylcysteine, ambroxol, bromelain or papain are also available, depending on the underlying disease. They can relieve the pressure on the inner ear canal, which not only reduces pain, but also prevents pressure-related ear damage. In addition, pain ointments and pain relievers such as ibuprofen can be taken. Here, however, a consultation with the ENT doctor should take place beforehand in order to dose the medication correctly.

Home remedies for stinging in the ear

The so-called Valsalva method helps with stinging pressure pains in the ear from staying in an airplane, mountaineering or diving. For this purpose, the nose is closed with the mouth closed and, at the same time, breathing firmly against it. The symptoms during a height shift can also be avoided by swallowing regularly.

When it comes to ear piercing caused by ear infections and other ENT diseases, targeted heat treatment is always of great benefit. For example, warming pillows or a (not too hot) hot water bottle can alleviate the pain symptoms in the area of ​​the ears. Steam baths, in turn, clear the airways and help to remove infection secretions. Other proven home remedies for earache are red light therapy, warm potato wrap that is placed on the ear or the tried and true hot tea.

Tip: As early as 1996, a study from Finland was able to demonstrate that the sugar derivative xylitol works successfully against otitis media. Xylitol apparently contains components that successfully kill infection germs responsible for otitis media. It is ideal to chew chewing gum containing the derivative. On the one hand, the xylitol reaches the middle ear faster through the throat. On the other hand, in combination with the chewing movement of the jaw, it also helps to strengthen the Eustachian tube and thus improve the ventilation of the middle ear.

Medicinal plant help

Warming teas are well suited for stinging in the ear to treat the underlying disease therapeutically. Herbs like are recommended

- chamomile,
- garlic,
- Mullein,
- lavender,
- lemon balm,
- Parsley,
- peppermint,
- sage,
- thyme
- and onion.

Some of these herbs can also be used as a spice for warm broths and other strengthening dishes. A peeled clove of garlic wrapped in cotton can also be placed directly in the ear, where the antibacterial components of the garlic quickly penetrate into the focus of infection.

Herbal additives for steam or medicinal baths are also recommended. When bathing, however, please make sure that no water gets into your ears to avoid worsening infections due to water residues.

Hygienic measures

An important step in the healing of ear infections, as well as in the relief of associated stinging pain, is the professional cleaning of the ear canal. Blocked ears can be removed by rinsing the ears. Disinfecting the ears with clear alcohol is also particularly effective against illness and pain symptoms. For this purpose, alcohol-soaked strips of linen are inserted into the ear, which are then changed at regular intervals until the inflammation has healed.

Important: It is advisable to have the line strips used by an experienced specialist for ear disinfection. The incorrect handling of tweezers or the too deep insertion of the strips could otherwise lead to injuries in the ear canal, which further increase the pain symptoms and the risk of inflammation. The situation is similar with ear irrigation, which should also be better carried out professionally by an ENT doctor.

Operative measures

Ears blocked by foreign objects occasionally require surgery to remove the blockages. This measure is very often used in children. Ears blocked by ear wax may also require surgery if rinsing does not help.

Hearing injuries as the cause of stinging ear pain usually have to be treated surgically. For example, tympanic tears can only be repaired by artificial sealing. Occasionally, the eardrum must also be opened artificially, for example to drain secretions.

If the hearing damage is particularly extensive, it may be necessary to consider completely replacing the affected hearing parts. Usually, the operation is limited to minimally invasive procedures. (ma)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Debara L. Tucci: Earache, MSD Manual, (accessed 08/28/2019), MSD
  • Jürgen Strutz (ed.), Wolf Mann (ed.), Practice of ENT medicine, head and neck surgery, Thieme Verlag, 3rd edition, 2017
  • Thomas Lenarz, Hans-Georg Boenninghaus: ENT, Springer-Verlag, 14th edition 2012


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