Persistent Ear Pain Without Inflammation: Should You Seek a Second Opinion?

The throat and ears are not inflamed, but the ears often hurt. Should I seek another doctor for an examination?

Hello, doctor.
I have a sensation of a foreign body in my throat that I can't cough up or swallow.
Sometimes I also produce white phlegm.
Currently, I am experiencing pain in both ears, but I do not have tinnitus or hearing issues.
I previously visited an ENT specialist who said that the dryness in my throat was the cause and that there was no inflammation.
They prescribed an expectorant and advised me to return in two months for a follow-up.
However, my ears continue to hurt frequently.
Should I see another doctor for further evaluation?

Miss Wang, 40~49 year old female. Ask Date: 2016/09/26

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you continue to feel unwell, it is advisable to consult another physician.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/09/26

More Info

Persistent ear pain can be a frustrating and concerning issue, especially when previous evaluations have not yielded a clear diagnosis or effective treatment. In your case, where you are experiencing ear pain without any signs of inflammation or hearing loss, it is indeed advisable to seek a second opinion from another healthcare professional, particularly an ear, nose, and throat (ENT) specialist.

There are several potential causes for persistent ear pain that may not be immediately apparent. One possibility is Eustachian tube dysfunction, which can occur when the tube that connects the middle ear to the back of the throat becomes blocked or fails to open properly. This can lead to a feeling of fullness in the ear, discomfort, and sometimes pain, especially during changes in altitude or pressure, such as when flying or during physical activity. Symptoms may also be exacerbated by environmental factors, such as allergies or sinus congestion.

Another consideration is referred pain from other areas, such as the throat or jaw. Conditions like temporomandibular joint (TMJ) dysfunction can cause pain that radiates to the ear. Similarly, throat issues, even in the absence of inflammation, can lead to sensations of discomfort that may be perceived as ear pain. The sensation of a foreign body in the throat, along with the production of phlegm, could indicate underlying issues that may require further investigation.

In your situation, since the initial evaluation did not reveal any inflammation and the prescribed treatment did not alleviate your symptoms, it would be prudent to consult another ENT specialist. A fresh perspective may lead to new insights or diagnostic tests that could identify the underlying cause of your discomfort. This could include imaging studies, such as a CT scan, to evaluate the sinuses and Eustachian tubes, or a more thorough examination of the throat and surrounding structures.

Additionally, consider discussing your symptoms in detail with the new physician, including the specific nature of your ear pain, any triggers you have noticed, and the impact on your daily life. This information can help guide the diagnostic process and ensure that all potential causes are considered.

In summary, persistent ear pain without clear inflammation warrants further investigation. Seeking a second opinion from another ENT specialist is a reasonable and proactive step. They may offer new diagnostic approaches or treatment options that could help alleviate your symptoms and improve your quality of life. Remember, your health and comfort are paramount, and it is essential to advocate for yourself in the healthcare system.

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