# Concern or fear of ear disease

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class HS90 - condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Recognition & Referral)

## Complete treatment card

```text
CONCERN OR FEAR OF EAR DISEASE
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class HS90 -
         condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf
         (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway,
         no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line]
   Adult    A patient presenting with anxiety regarding ear disease requires a thorough otoscopic
            examination and basic hearing assessment (whisper voice test, Weber and Rinne tuning
            fork tests) to rule out physical pathology such as otitis media, tympanic perforation,
            cerumen impaction, or cholesteatoma. Reassure the patient once organic disease is
            excluded and explain how stress or somatization can amplify benign auditory sensations
            or mild subjective tinnitus. Refer to ENT if objective hearing loss or structural
            lesions are identified, or to psychological services if health anxiety remains
            debilitating. - Refer
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      A patient presenting with anxiety regarding ear disease requires a thorough otoscopic
            examination and basic hearing assessment (whisper voice test, Weber and Rinne tuning
            fork tests) to rule out physical pathology such as otitis media, tympanic perforation,
            cerumen impaction, or cholesteatoma. Reassure the patient once organic disease is
            excluded and explain how stress or somatization can amplify benign auditory sensations
            or mild subjective tinnitus. Refer to ENT if objective hearing loss or structural
            lesions are identified, or to psychological services if health anxiety remains
            debilitating.
   Caution  RED FLAG - Associated cranial nerve palsies, facial asymmetry, or true rotational
            vertigo with nystagmus: assess urgently and refer.
            RED FLAG - Post-auricular swelling, erythema, and tenderness indicating acute
            mastoiditis: assess urgently and refer.
            Make sure a genuine symptom (pain, discharge, hearing loss) is not being dismissed as
            anxiety.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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