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A patient with a painful ear often requires urgent attention and most of these cases are expected to have acute otitis media. It can occur at any age but is most common in children where otitis media is the most common cause. Ear ache can be caused by disorders of the ear or may arise from other surrounding structures and in many instances the precise diagnosis is difficult to make. Some of the conditions of the external ear that can cause otalgia include otitis externa, perichondritis, furunculosis, trauma, wax impaction and viral infections. In the middle ear it is most commonly acute otitis media, acute mastoiditis and eustachian tube insufficiency. Pain from the surrounding areas can be referred such as dental idsorders, parotitis, cervical dyfunction and lymph node inflammation.
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