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#MedEd #Tweetorial on EAR PAIN

Because I keep seeing antibiotic prescriptions for non-infected ears! 👂🗯️ Hark, #medtwitter:

About half of ear pain is due to the ear itself: otogenic otalgia.

About half of ear pain is due to a problem outside the ear: referred otalgia.

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Otogenic otalgia is usually otitis externa or otitis media.

Patients with otitis externa ("swimmer's ear") tend to have drainage, and tenderness with moving the auricle.

Their canal will look like this diagram. "Slightly red," no edema, no pus, is not otitis externa.

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Patients with otitis media tend to have reduced hearing. Often they recently had a URI.

Exam findings include bulging or opaque eardrum, reduced tympanic membrane mobility, and conductive hearing loss.

(Don't give drops if TM is intact: how would abx reach the infection?)

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