Persistent Ear Pain After Accident: When to Seek Further Medical Help

Ear problems

I was involved in a car accident yesterday afternoon.
After a brief examination, the emergency physician recommended that I stay in the hospital for two hours for observation to see if I experienced any further discomfort.
About an hour after that, I started to experience ear pain.
The doctor referred me to an otolaryngologist, who conducted a hearing test that showed no issues.
However, the ear pain persists, and the doctor prescribed pain medication.
Even today, the pain in my ear continues.
Should I be referred to another specialist for further evaluation?

Eva, 20~29 year old female. Ask Date: 2018/11/14

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issues you mentioned may have the following two possibilities:
1) Otitis Media:
a) Acute Otitis Media: Often occurs alongside upper respiratory infections (colds) and sinusitis.
In severe cases, there may be ear discharge or pus.
b) Chronic Otitis Media with acute exacerbation: This usually involves a perforated eardrum, which can be caused by unclean water or improper ear cleaning, leading to inflammation.
Treatment for mild cases may include ear drops combined with oral medications (antibiotics, anti-inflammatory pain relievers, etc.), while severe cases may require hospitalization.
If hearing is affected, it is advisable to seek medical attention promptly.
2) Temporomandibular Joint Disorder (TMJ): This condition occurs in the joint located in front of the ear and is often confused with ear pain.
It is commonly caused by poor bite habits and can be managed with medications and adjustments to biting habits.
3) Eustachian Tube Dysfunction: This can occur during activities such as flying, mountain climbing, or diving, and may also result from forceful nose blowing or bending over.
If symptoms persist, it is recommended to seek medical evaluation and treatment.
Wishing you safety and good health.
Sincerely,
Dr.
Chi Chao-Yun
Director, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare

Reply Date: 2018/11/14

More Info

Experiencing persistent ear pain after an accident can be concerning, especially when initial evaluations do not reveal any immediate issues. In your case, it seems you have already undergone a thorough examination by an emergency physician and an ENT specialist, who performed a hearing test that returned normal results. However, the ongoing pain indicates that further evaluation may be necessary.

There are several potential causes for your persistent ear pain following the accident. Here are some possibilities:
1. Trauma to the Ear: Even if the hearing test is normal, trauma from the accident could have caused inflammation or injury to the structures of the ear, such as the eardrum or the middle ear. This can lead to pain that may not be immediately apparent.

2. Middle Ear Issues: Conditions like acute otitis media (middle ear infection) or eustachian tube dysfunction can develop after trauma. These conditions may not always present with obvious symptoms initially but can cause significant discomfort over time.

3. Temporomandibular Joint (TMJ) Dysfunction: The TMJ is located near the ear, and trauma can lead to issues with this joint, resulting in referred pain to the ear. Symptoms can include pain when chewing, clicking sounds, or discomfort in the jaw.

4. Cervical Spine Issues: Whiplash or other neck injuries from the accident can also manifest as ear pain. The nerves that supply sensation to the ear can be affected by cervical spine injuries, leading to referred pain.

5. Nerve Damage: In some cases, trauma can lead to nerve damage, which may cause persistent pain or discomfort in the ear.

Given that your pain has not improved with pain medication and is affecting your quality of life, it would be advisable to seek further medical evaluation. Here are some steps you can consider:
- Follow-Up with an ENT Specialist: Since your pain persists, returning to an ENT specialist for a more comprehensive evaluation is a good idea. They may consider imaging studies, such as a CT scan, to assess for any hidden injuries or complications.

- Consult a Pain Specialist: If the ENT evaluation does not yield answers, consulting a pain management specialist may help identify the source of your pain and provide additional treatment options.

- Physical Therapy: If TMJ dysfunction or cervical spine issues are suspected, physical therapy may be beneficial. A physical therapist can provide exercises and treatments to alleviate pain and improve function.

- Monitor Symptoms: Keep track of any additional symptoms that may arise, such as changes in hearing, dizziness, or any new pain. This information can be crucial for your healthcare providers in determining the underlying cause of your discomfort.

In summary, while your initial evaluations were reassuring, the persistence of your ear pain warrants further investigation. It is essential to advocate for your health and seek additional opinions or tests if your symptoms do not improve. Your well-being is paramount, and addressing this issue sooner rather than later can help prevent further complications.

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