Painful Ear Bumps and Headaches: When to Seek ENT Care

Acne on the ear and headache?

Recently, an elderly family member developed a pimple-like growth in the ear and visited an otolaryngology clinic, initially thinking it was not serious.
However, they experienced severe headaches every night, which became unbearable, prompting a visit to the emergency department.
The emergency physician only managed the symptoms by administering pain relief but did not conduct any further examinations.
The symptoms have persisted for nearly two weeks without any relief, and hospitalization for observation is not an option.
The elderly patient has a history of herpes zoster.
Please advise.

Jiazhong Zhangbei, 80~89 year old female. Ask Date: 2015/12/10

Dr. Zheng Jueyi reply Otolaryngology

If the headache persists, it is recommended to return to the otolaryngology department for a follow-up consultation to determine if the pain is caused by inner ear inflammation or the presence of foreign objects, or if there are other factors involved, such as post-herpetic neuralgia.
If it is neuralgia, a referral to a neurologist for evaluation and treatment may be necessary.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/10

More Info

When dealing with painful ear bumps and persistent headaches, it is essential to understand the potential underlying causes and when to seek further medical evaluation. In your case, the presence of bumps in the ear, combined with severe headaches that have lasted for nearly two weeks, warrants a thorough examination by an Ear, Nose, and Throat (ENT) specialist.

The bumps you describe could be a result of several conditions, including but not limited to:
1. Ear Canal Infections (Otitis Externa): This is an infection of the outer ear canal, often caused by bacteria or fungi. Symptoms can include itching, redness, swelling, and sometimes painful bumps. If the infection spreads or is severe, it can lead to headaches.

2. Sebaceous Cysts: These are non-cancerous lumps that can form in the ear canal. They can become inflamed or infected, leading to pain and discomfort.

3. Folliculitis: This is an infection of the hair follicles that can occur in the ear area, leading to painful bumps and potential headaches.

4. Herpes Zoster Oticus (Ramsay Hunt Syndrome): Given the history of shingles (herpes zoster), it is crucial to consider this condition. It can cause painful blisters in the ear and can lead to severe headaches, vertigo, and even facial paralysis.

5. Referred Pain: Sometimes, issues in the ear can lead to referred pain in the head, causing headaches that may not directly relate to the ear condition.

Given that the emergency department only provided symptomatic relief without further investigation, it is advisable to return to an ENT specialist for a comprehensive evaluation. This may include:
- Physical Examination: A thorough examination of the ear canal and surrounding structures to identify any signs of infection, inflammation, or other abnormalities.

- Imaging Studies: Depending on the findings, imaging studies such as a CT scan or MRI may be necessary to rule out any serious underlying conditions.

- Laboratory Tests: If an infection is suspected, cultures may be taken to identify the causative organism and guide appropriate treatment.

In the meantime, managing pain with over-the-counter analgesics like acetaminophen or ibuprofen can help, but it is crucial to address the underlying cause of the symptoms. If the pain worsens, or if new symptoms arise (such as fever, drainage from the ear, or changes in hearing), seek immediate medical attention.

In summary, while symptomatic treatment can provide temporary relief, persistent symptoms, especially in the context of a history of shingles, necessitate further evaluation by an ENT specialist. Early intervention can prevent complications and lead to a more effective treatment plan.

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