The most common cause of earache is infection, either of the outer ear (otitis externa) also known as "swimmer's ear", or, the middle ear (otitis media). The middle ear is closely connected with the nose and the throat and any inflammation of these parts easily spreads to the middle ear. Thus, earache may be a complication of the common cold, tonsillitis, influenza or the infectious fevers of childhood. Children often can't convey that they have pain in the ear. If a young child is crying, unwell, feverish, pulling at the ear or has a red ear, suspect earache. High altitudes and cold temperatures increase discomfort and can worsen an infection. Occasionally pain in or near the ears may be a symptom of neuralgia, tooth abscess or other facial conditions.
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