ICD-10 Codes for ear pain | Earache

The first step in evaluating otalgia includes a comprehensive history and physical examination. Evaluation should exclude red flags and risk factors for a serious diagnosis. If found, then head & neck CT and MRI, panendoscopy, including nasolaryngoscopy and direct visualization of the upper aerodigestive tract, can be ordered. Gastrointestinal red flags should prompt a barium swallow or referral to gastroenterology for esophagogastroduodenoscopy (EGD). Chest pain and cardiac risk factors should prompt a full cardiac work-up. Clinical signs of temporal arteritis should prompt an ESR. An ESR greater than 50mm per hour indicates the need for an urgent referral to ophthalmology and otolaryngology. Treatment of otalgia is dependent on the diagnosis. Infections cause most primary otalgia and are treated with antibiotics, while mechanical receive treatment with decongestants, nasal steroids, or myringotomy. Secondary causes include a wide variety of diagnoses. One notable management point is the need for urgent referral and steroid treatment for temporal arteritis, a rare cause of secondary otalgia. Therapy otherwise addresses the underlying medical condition, such as malignancy, dental caries, temporomandibular joint disease, coronary artery disease, or gastroesophageal reflux. Patients who have an unremarkable clinical evaluation and no red flags or risk factors for serious disease can be treated conservatively with analgesics and re-evaluated in 4 weeks.