The patients often complain about drawing, described as very unpleasant pain in the ear (earache). Often also dull, oppressive pain are described. In addition, many patients also complain of hearing disorders (dull listener life) in one or both ears. Often the ear pain is also accompanied by a limited general condition and fever. At times, the pain also goes to the head. Patients sometimes complain of restlessness and irritability, covering their ears and applying light pressure with their hands.
In addition to the medical interview (anamnesis), in which the doctor always interrogates the type of pain, the duration and the onset, the examination of the ear will initially represent the most important diagnostic means from the outside, later from the inside. For external examination he will look at the auricle and the externally visible area of the ear to detect swelling and redness. Eventually, the typical overheating of the ear, which is typical for an inflammation, will be determined by palpation.
Afterwards he will examine the ear canal and the eardrum by means of a so-called otoscopy. The instrument (otoscope) is provided with a light, introduced into the ear canal and pushed up to the eardrum. The doctor recognizes injuries or redness and narrowing of the ear canal and can look at the eardrum. This should create a light reflex and should neither bulge outwards nor be pressed inwards. Furthermore, hemorrhages and tears of the eardrum could be seen with this diagnostic method. The light reflex produced by the otoscope on a healthy eardrum must be in the right place. In a middle ear infection, the reflex is often gone.
If the doctor does not find a disease in this examination and the ear pain persists, then an otorhinolaryngologist should definitely be consulted and a computed tomography scan of the skull should be considered in order to rule out a tumorous cause.