why does the cartilage in my ear hurt

The cartilage of the can become inflamed, causing, redness and
of the outer ear. The cartilage, found in the outer ear, is a springy, supple type known as elastic cartilage. Although not as hard as bone, it is a tough material that provides the shape of the ear. However, unlike other tissues in the body such as and muscle, cartilage does not have its own supply, so damaged cartilage takes longer to heal than other tissues. The perichondrium, the soft tissue that sits alongside the cartilage, provides the cartilage with a supply of blood. If it becomes detached, the cartilage can die off and shrink, forming a deformed 'cauliflower' ear, so-called for its irregular shape. Sometimes the cartilage can become inflamed, swelling up and causing of the outer ear, which becomes red. Inflammation can occur due to pressure, stress or injury to the ear. Inflammation of cartilage is known as chronditis; when the cartilage and its surrounding soft tissues are inflamed it is known as perichronditis. The ear is the most common location for perichronditis. What causes inflammation of ear cartilage? Ear piercings : Piercings in the upper third of the ear that go through the cartilage instead of the ear lobe, sometimes called 'high' ear piercings, are more prone to becoming infected by Pseudomonas aeruginosa or Staphylococcus aureus. If untreated, an can form and the cartilage can die off, forming a cauliflower ear. Cuts to the ear : A cut, or laceration, to the ear can become infected and inflamed. Trauma to the ear :A blow or impact to the ear can lead to inflammation if blood accumulates between the cartilage and perichondrium. Trauma is a common cause of cauliflower ear. Complication of surgery : Inflammation can occur as a result of surgery such as otoplasty or pinnaplasty to reshape an ear or when removing a lesion in the middle ear such as cholesteatoma. Polychondritis (relapsing polychondritis) : A rare condition in which cartilage in several areas of the body, especially the ears, nose and airways of the, becomes inflamed. It occurs most often in people in their fifties and sixties but the cause is unknown; diagnosis may be made through a. How is inflammation of ear cartilage treated? Treatment will depend on the cause and stage of inflammation. : Penicillin may be prescribed along with, co-amoxiclav or if the ear is cut. Antibiotics are also prescribed when treating an abscess. Antipseudomonal : Oral, intravenous tricarcillin or piperacillin may be used for the early stages of infection from a 'high' ear piercing.

If the infection fails to respond to treatment, the person may be referred to an ear, nose and throat specialist. Draining an abscess : An incision will be made to drain an abscess. Once the fluid is drained, which can take 24в72 hours, may be needed to ensure the perichondrium doesn't become detached from the cartilage. In severe cases, such as in cauliflower ear, surgery may be used to remove dead cartilage and. There is no established treatment for polychondritis, but treatment may involve a medication normally used for or an immunosuppressive medication. Pain in the ear is either due to a condition that directly affects the ear, or is referred from the surrounding areas. Ear pain is a common symptom that could occur either due to a problem in the ear itself or a neighboring part of the head or face. Ear pain due to a local cause is usually detected on ear examination. For example, an infection or a foreign body can be directly diagnosed through ear examination. If this examination does not show any abnormality, the surrounding structures like the mouth should also be examined. The ear is made up of three parts: the external or outer ear, the middle ear and the inner ear. The external ear extends through the ear canal till the eardrum. The middle ear extends from the eardrum till a spiral structure called the cochlea, which forms the internal ear. Conditions that cause ear pain are usually located in the external or middle ear. Conditions affecting the ear: Acute Otitis Externa : Otitis externa refers to infection of the external or outer ear. The patient complains of pain when the examiner pulls the cartilage of the ear or presses on the tragus (the small cartilaginous projection in front of the ear). The ear canal may be red and swollen. The infection may follow an insect bite, scratch or ear piercing. Acute Otitis Media : Acute otitis media is an infection of the middle ear and is one of the more common causes of ear pain. On examination of the ear, the eardrum may be red and bulging. In some cases especially in diabetes patients or patients with reduced immunity, the infection and pain can be severe; the condition is referred to as malignant otitis externa. Foreign Body in Ear : Foreign bodies inserted in the ears are common causes of ear pain in children.

The foreign body is usually visible in the ear canal on examination and can be removed with a curette or a forceps. In some cases, excessive ear wax can result in ear pain. Changes in External Pressure : Changes in external pressure can result in ear pain. This situation is frequently experienced during a flight or while scuba diving. The pain usually subsides on its own. In some cases however, the pressure changes can damage the eardrum resulting in accumulation of fluid or blood in the middle ear. Trauma : Trauma to the ear due to injury can cause pain of the ear. A history of trauma is usually present in these patients. Cancer of the External Ear : Squamous cell cancer, a cancer affecting the external ear, is a rare cause of ear pain. The pain tends to be severe, deep and unrelenting. Ramsay Hunt Syndrome : Ramsay Hunt Syndrome is a condition where the nerves supplying to the area near the ear are affected by a viral infection called herpes zoster. The patient complains of features like ear pain, paralysis of the face and the presence of fluid-filled boils in the ear canal. Other associated symptoms include hearing loss, ringing in the ear, vertigo and taste disturbances. Relapsing Polychondritis : Relapsing polychondritis is a condition that affects the cartilages of different parts of the body including the ear. The ears appear red in color. However, the earlobe, which lacks cartilage, appears normal. The condition keeps relapsing. Cartilages in other organs are also often involved, which include the eyes, nose, heart, kidneys and the nervous system. Conditions Causing Referred Pain to the Ear TMJ Syndrome : The TMJ is the jaw joint. TMJ syndrome is a condition where the patient experiences ear pain especially while moving the jaw during activities like talking or chewing. Examination of the joint may elicit pain and a crepitus sound on moving the joint. The pain may subside with painkillers and a soft diet. Dental Causes : Pain in the molars due to caries, abscess or due to impaction of the molar can lead to referred pain in the ear. It is therefore extremely important to check the teeth in a patient complaining of ear pain. Sore Throat : Sore throat or enlarged and infected tonsils can result in ear pain. Again, this condition is diagnosed on examination of the mouth. Tumors of the face and neck region : Tumors of nose, mouth, neck and chest can rarely cause ear pain.

The patient may show symptoms like difficulty with swallowing, hoarseness or weight loss. He/she may also give a history of smoking. Neuralgias : Neuralgias are conditions that affect nerves and cause severe pain in the distribution of the nerve. Neuralgias that cause severe pain around the face include trigeminal neuralgia, glossopharyngeal neuralgia and sphenopalatine neuralgia. The pain is often sharp, shooting, and severe and appears in paroxysms. Temporal Arteritis : Temporal arteritis is a condition that affects the blood vessels at the temple area. This pain may refer to the ear. The patient complains of pain when pressure is applied to the temporal arteries. The ESR test, which is a blood test, is usually abnormal in these patients. Cervical Spine Arthritis : Neck pain due to arthritis can also be referred to the ear. It is therefore necessary to examine the neck as well in a patient complaining of ear pain, especially if the ear examination is normal. 1. Which doctor should I visit in case I suffer from ear pain? You should visit an ENT (Ear-Nose-Throat) specialist in case you suffer from ear pain. 2. Why dont diseases of the inner ear produce pain? The inner ear is supplied by nerves that do not have pain fibers. Therefore, diseases of the inner ear usually do not produce pain. Dear Dr. Roach: Please, please help me. IБve visited my allergist, the ear-nose-throat specialist and my own internist. None of them has ever heard of my problem and don't know how to help me. Starting in 1990, every couple of months I would get an awful pain on one of my ears if I had been lying on it during the night. It would happen to either ear, whichever one I lay on. I went to an ear-nose-throat specialist then, who did not know what to make of it. The pain is so intense that it wakes me. It is not inside the ear but around the edges of the entrance to it. It is so painful that I canБt touch it. It will be throbbing. The only thing that will make it go away is when I stand up. Within 30 minutes, it is gone. I even tested it by massaging behind the ear (once I could bear to touch it), and it seemed to make the pain go away faster. The ENT said my ears are healthy. I am very much afraid that the day will come when I will no longer be able to lie down in my bed to go to sleep. I just had an MRI done, and the reading shows no Бgrowths,Б according to my doctorБs office.

This ear pain, however, is starting to affect my daily living, since I donБt seem to be able to get the restful sleep I need. L. T. Without doing an exam, obviously I canБt be sure, but I wonder if you have relapsing polychondritis. БRelapsingБ means that it comes and goes, and БpolychondritisБ means there's inflammation of different cartilage in the body. The firm, flexible tissue in the ears is cartilage, as is the firm tissue in your nose and your windpipe. Relapsing polychondritis is a rare disease, often with a long delay in diagnosis due to its rarity and intermittent nature. It can affect just one or two areas, as might be the case with you, but it also can affect joints and critical organs, like lungs, heart, kidneys and blood vessels. It appears to be an autoimmune disease, one in which the bodyБs defence system attacks its own cartilage. Usually, there is some redness or swelling of the cartilage. Treatment varies with severity of the disease. Sometimes anti-inflammatories work wonders; other times, people need very powerful immune-suppression drugs. A rheumatologist is most likely to be familiar with this condition. I found a nice support group at health. groups. yahoo. com/group/Rpolychondritis/. Dear Dr. Roach: I have major back pain. IБve been to the emergency room and seen many doctors. One gave me hydrocodone then stopped and accused me of being an addict. I canБt do anything strenuous: just cleaning house leaves me in tears. Is an operation my only choice? S. G. In general, there are three kinds of treatment for low-back pain: medication, therapy and surgery. Medications include anti-inflammatories, Tylenol and narcotics, but narcotics like hydrocodone are the least preferred due to both side effects and recent data showing that they donБt help over the long term. I am sure it must be very frustrating to try to find a medication to help you and be wrongly labelled an Бaddict. Б It can take patience to find a medication that helps. By therapy, I mean physical therapy, but also acupuncture and chiropractic treatments, which are helpful in many cases. Surgery is an option, but only for particular types of back pain (confirmed by MRI or other imaging) that arenБt getting better with other treatments. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to

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