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Wizards of Waverly Place (season 4)
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Wizards of Waverly Place (season 4)
The Wizards of Waverly Place season 4 main cast
Country of origin
United States
No. of episodes
27
Release
Original network
Disney Channel
Original release
November 12, 2010 (2010-11-12) – January 6, 2012 (2012-01-06)
Season chronology
← Previous
Season 3
The fourth and final season of Wizards of Waverly Place aired on Disney Channel from November 12, 2010 to January 6, 2012. The Russo children, Alex (Selena Gomez), Justin (David Henrie), and Max Russo (Jake T. Austin) continue to compete to become the leading wizard in their magical family and begin to make difficult decisions about their futures. Maria Canals Barrera and David DeLuise co-star as their parents and Jennifer Stone co-stars as Alex's best friend, Harper Finkle. This is the second season of the series to be broadcast in high-definition.
Contents
[hide]
1 Opening sequence
2 Synopsis
3 Cast
4 Episodes
5 References
6 External links
Opening sequence[edit]
Season 4 of the series features a revamped opening sequence with clips from past seasons. The opening sequence takes place in the wizard lair at the Russo home. Footage of Alex (Selena Gomez) and Justin Russo (David Henrie) is shown in the Crystal replay ball from the season premiere "Alex Tells the World". Then, a spell book opens and footage of Max Russo (Jake T. Austin) and Harper Finkle (Jennifer Stone) appear. After that, footage of Theresa (Maria Canals Barrera) and Jerry Russo (David DeLuise) are shown in a cauldron. After the footage is played, Alex transports them to Times Square, with Alex waving her wand to reveal the title logo and the name of the creator. The theme song Everything Is Not What It Seems has also been remixed and sung by Selena Gomez for the fourth season of the show.
Synopsis[edit]
Alex and Justin are sent back to level one in the wizard competition after "exposing" wizardry in "Alex Tells the World", leaving Max as the most expected to become the family wizard. In "Alex Gives Up", Alex quits the competition, but eventually decides to stay in the competition in "Journey to the Center of Mason" to be with Mason. Before then, Harper tries to get Alex to enjoy life without wizardry. Meanwhile, Justin tries to tutor a class of delinquent wizards.
In the episode, "Three Maxes and a Little Lady", Alex and Justin accidentally turn Max into a little girl, Maxine, portrayed by Bailee Madison. She ends up making Alex jealous when their father prefers Maxine over Alex. Maxine remains until "Back to Max". In the episode "Everything's Rosie for Justin", Justin falls in love with Rosie, a guardian angel, but at the end of "Dancing with Angels" she becomes an Angel of Darkness. In "Zeke Finds Out", the Russos finally reveal to Zeke that they are wizards. In "Wizard of the Year", Alex is crowned Wizard of the Year for saving the world from the angels of darkness, and is reinstated in the Wizards Competition. In "Justin's Back In", Justin is reinstated in the Wizard Competition, after his class of delinquent wizards passes.
Meanwhile, Alex's relationship with Mason is jeopardized again when a beast tamer, Chase Riprock, falls in love with Alex and Mason gets jealous. This results in Alex breaking up with Mason. Alex, Justin and Max then save the world from being destroyed by an asteroid. Later, Alex and Harper move into an apartment building with a secret 13th floor for wizards and other creatures in the wizard world. However, it turns out to be a trap made by Gorog to capture the wizards who live in the same floor to make them join the dark side and rule the wizard world. He is defeated and destroyed by Alex, Justin and Max who were using the Power of Three. During this, Alex and Mason get back together and, after a long time, Justin finally gets back together with Juliet.
Finally, in the hour-long series finale, Alex, Justin, and Max compete in the family wizard competition. Alex wins and gains full wizardry; Justin becomes a full wizard as well when Professor Crumbs reveals he is retiring as headmaster of WizTech and passes the position to Justin. Jerry also decides to pass down the Waverly Sub Station to Max one day since he is the only child who is not a wizard anymore. The series ends with hugging and Alex saying that they are all happy.
Guest stars and recurring cast include: Gregg Sulkin as Mason Greybeck, Ian Abercrombie as Professor Crumbs, David Barrera as Carlos Cucuy, Samantha Boscarino as Lisa Cucuy, Bill Chott as Mr. Laritate, Frank Pacheco as Felix, Bridgit Mendler as Juliet van Heusen, Daniel Samonas as Dean Moriarty, Bailee Madison as Maxine Russo, Shane Harper as Fidel, Dan Benson as Zeke Beakerman, John Rubinstein as Gorog, Andy Kindler as Chancellor Tootietootie, Fred Stoller as Dexter, Leven Rambin as Rosie, China Anne McClain as Tina, Kari Wahlgren as Helen, Cameron Sanders as Nelvis, Josh Sussman as Hugh Normous, Jackie Evancho as Herself, McKaley Miller as Talia, Valente Rodriguez as Muy Macho, and Nick Roux as Chase Riprock.
Cast[edit]
Selena Gomez as Alex Russo
David Henrie as Justin Russo
Jake T. Austin as Max Russo
Jennifer Stone as Harper Finkle
Maria Canals Barrera as Theresa Russo
David DeLuise as Jerry Russo
Episodes[edit]
Main article: List of Wizards of Waverly Place episodes
This season consists of 27 episodes.
Wizards of Waverly Place Season 4 episodes
No.
overall
No. in
season
Title
Directed by
Written by
Original air date
Prod.
code [1]
U.S. viewers
(millions)
80
1 "Alex Tells the World" Victor Gonzalez Gigi McCreery & Perry Rein November 12, 2010 (2010-11-12) 401 4.1[2]
The Russos and Mason finally make it back home, but their wizard powers are still gone. While the family wants to stay quiet, Alex believes that they should take action, so she reveals that they are wizards to reporters and tells them that a group of wizards are being held captive by the government. As she urges them to spread the word, Professor Crumbs appears and tells her that everything that had happened was a test that she failed miserably and orders her to Wizard Court for exposing wizardry to the world. Justin is also ordered to attend because he exposed magic to Agent Lamwood, who was a creation from Professor Crumbs' mind. The judges rule Alex and Justin guilty, and Professor Crumbs sentences them both to be demoted to level one in the Family Wizard Competition, making them behind Max by two levels. Meanwhile, Max sets up traps in the Sub Station for the "government", but ends up falling for one of them.
Special guest star: Gregg Sulkin as Mason
Guest star: Ian Abercrombie as Professor Crumbs
81
2 "Alex Gives Up" Victor Gonzalez Todd J. Greenwald November 27, 2010 (2010-11-27) 402 N/A
Alex decides to give up the wizard competition to spend more time with Mason and thinks that it does not matter since Max is all the way in the lead, but Chancellor Tootietootie tells Alex that non-wizards and werewolves cannot date, because the werewolf always eats the human. Max's picture on the front of Future Wizards magazine attracts the daughter of a family of Cucuys (mythical Latino monster) and they invite him to a dinner party on their yacht. Alex comes up with a scheme to invite Chancellor Tootietootie to the Cucuy party in hopes of getting him to appeal the law against werewolves and mortals dating. Lisa Cucuy finds out that Mason is a werewolf and decides that she wants him instead of Max. Alex gets jealous when Lisa flirts with Mason, so Alex says embarrassing things about Mason to everyone on the yacht so that he will be mad enough to turn into a werewolf. Carlos and Julie Cucuy jump off the boat as Cucuys are scared of werewolves. Jerry jumps off after them. Alex tells Lisa that she can get off the boat the easy way or her way. Once Lisa jumps off the boat, Chancellor Tootietootie says that their case will not be appealed as by Mason turning into a werewolf proved his point that they are dangerous. In the end, Alex and Mason have to break up to be friends and Harper finishes writing her first novel based on the werewolf-wizard relationship. Jerry tries to get Harper to help him out of the water but accidentally grabs her just finished novel, which causes him to fall back into the water. Meanwhile, Justin tutors a class of delinquent wizards in an attempt to gain a level to re-enter the Wizard Competition.
Special guest star: Gregg Sulkin as Mason
Guest stars: Andy Kindler as Chancellor Tootietootie, Frank Pacheco as Felix, David Barrera as Carlos Cucuy, Roxana Brusso as Julie Cucuy, Samantha Boscarino as Lisa Cucuy, Kari Wahlgren as Helen
82
3 "Lucky Charmed" Victor Gonzalez Justin Varava December 10, 2010 (2010-12-10) 403 3.0[3]
Harper tries teaching Alex how to live without magic, but the strain of taking responsibility for her actions instead of using magic causes a disagreement between the two best friends when Alex gets in big trouble for crashing Mr. Laritate's car. As punishment, Alex has to clean the school's garbage cans. Mr. Laritate forgives Alex after seeing how the crash influenced her, and Alex realizes that she will be okay without magic. Wanting to thank Harper, Alex uses Mr. Laritate's lucky life-saving hula girl figurine, Leilani, for luck, as Mr. Laritate does. During Harper's driving test, Alex turns into the hula girl and guides Harper through the test, knowing that she might fail. In the end, Harper passes her test. Meanwhile, Jerry wants to pass on the wizard family robe to Max, but Justin has a hard time letting go of it.
Guest stars: Bill Chott as Mr. Laritate, Julio Oscar Mechoso as DMV Instructor
Absent: Maria Canals Barrera as Theresa Russo
83
4 "Journey to the Center of Mason" Robbie Countryman Peter Dirksen December 17, 2010 (2010-12-17) 404 N/A
After she finds out that she will lose her powers, Alex can no longer date Mason, so they decide to try being best friends instead. After watching a film at the theaters, Harper, Alex, and Mason go home, Dean, who was Alex's Ex-Boyfriend comes and asks Alex to get back together with him. Mason gets jealous. When Dean brings a gift for Alex, Mason then asks what Alex's relationship is with Dean, and Max tells him that Dean and Alex used to date, making Mason more jealous. Mason then turns into a werewolf and eats Dean. Alex, Justin, and Max come up with a solution to turn Justin's toy Captain Jim Bob submarine big and go in it. They then shrink it and go into Mason's mouth. While there, Alex, Max, and Justin see Mason's thoughts, which are all of Alex. They get Dean out, and Alex, when Harper, Max, and Justin leave, Alex tells Dean that he was knocked out and the doctor's solution was for them all to dress up as cows. Dean then gives her his offer once again: he wants to get back with her. Alex tells him 'no', and then gets back together with Mason, with deciding to get back to the Wizard Competition.
Special guest star: Gregg Sulkin as Mason
Guest stars: Daniel Samonas as Dean, Frank Pacheco as Felix, Shoshana Bush as Tyler
84
5 "Three Maxes and a Little Lady" Victor Gonzalez Richard Goodman January 7, 2011 (2011-01-07) 405 4.0[4]
Alex joins Justin's wizard class to try to move up in the competition. Max joins a sophisticated wizard society. They suggest he move the wizard competition up and he moves it to a few days away. Max quits the society because he finds out that they are taking advantage of him. Alex and Justin transform into Max in an attempt to change the date of the family wizard competition back to its original date and succeed. In the end of the episode they accidentally turn Max indefinitely into a little girl.
Guest stars: Bailee Madison as Maxine, Frank Pacheco as Felix, Kari Wahlgren as Helen, Shane Harper as Fidel
Note: Bailee Madison begins her recurring role as Maxine, the female Max in this episode. Jake T. Austin was absent in four other episodes and returns at the end of the tenth episode "Back to Max".
85
6 "Daddy's Little Girl" Robbie Countryman Gigi McCreery & Perry Rein January 21, 2011 (2011-01-21) 406 3.4[5]
With Max still a little girl, their parents pay more attention to Max (Maxine), and Alex becomes jealous. Justin takes Maxine to her (Max's) karate class and Maxine kicks Justin's butt. After the class, Alex decides to make Jerry's favorite sandwich in order to win his love back, but Maxine comes along with Justin, announcing that she beat Justin in karate, and Jerry immediately falls for her cuteness again. More jealous than ever, Alex comes back with Justin to Maxine's karate class with their parents, having a slight idea of knowing how to change Maxine back to Max. They cast spells on Maxine, Justin using the spell he used on Max that turned him into Maxine, and Alex using the reverse spell. Unfortunately, it only makes Maxine cuter, which makes her furious. Instead of going against the person she was supposed to, she demands that she kicks either Alex or Justin's butt. Justin goes against her, but seeing that he would lose, Alex casts a spell on Justin to make him a karate master. Too fast for Maxine, Justin beats her, and Maxine is hurt (physically). Jerry and Theresa rush to her side, caring for Maxine more than they care that Justin beat Maxine in karate. Justin leaves, and Alex leaves after him, heartbroken. Back at home, Jerry tells Alex that he fell for Maxine because she reminded him of Alex when she was little and they bond again. Meanwhile, Zeke thinks the Russos hate him, but really it was just Harper's alibi in order to keep him away from the Sub Station so as not to make him suspicious about Max's disappearance and Maxine's appearance.
Guest stars: Bailee Madison as Maxine, Dan Benson as Zeke, Lanny Joon as Sensei
Absent: Jake T. Austin as Max Russo
86
7 "Everything's Rosie for Justin" Victor Gonzalez Justin Varava February 4, 2011 (2011-02-04) 407 3.9[6]
Justin and his delinquent class have a wizard wand dance assessment to do which will get them back in Wiztech. A new student named Rosie joins, whom Justin falls madly in love with to later find out that she is an Angel. Meanwhile, Jerry, Teresa, and Harper try to think of ideas of how to get more people to come to their restaurant. Harper makes cards which customers get hole punched each time they buy a sandwich; when you get 9 hole punches, they get a free sandwich. Contrary to the original purpose, one man punches his own card, demands a free sandwich, and then brings dozens of people into the restaurant, who also have pre-punched cards. Maxine uses her charming cuteness to convince the customers to not exploit her parents. Meanwhile, Justin kicks Rosie out of his class so that it does not fail the wizard dance assessment. Sympathizing, Alex gets Rosie to rejoin the class and puts a copycat spell on her so that Rosie can mimic Alex's move and pass the class. The assessment ends in disaster when a squirrel-frog attaches itself to Alex's foot, and Rosie reveals herself to be an angel. The class fails, but Justin starts dating Rosie.
Guest stars: Bailee Madison as Maxine, Frank Pacheco as Felix, Leven Rambin as Rosie, Diane Delano as Penny, Chris Coppola as Customer, Cameron Sanders as Nelvis
Absent: Jake T. Austin as Max Russo
87
8 "Dancing with Angels" Victor Gonzalez Richard Goodman February 11, 2011 (2011-02-11) 408 4.5[7]
Justin and Rosie start dating but when their date gets ruined, they want a second date. Alex suggests an Angel Club in Los Angeles, but Rosie says that only Angels are allowed. Maxine will not tell their parents as long as Alex brings her back an Ozzy Osbourne stone. After Justin, Harper and Alex sneak in along with Rosie, Zeedrik asks them if they are angels and they say they are. Back at the sub shop, Theresa and Jerry question Maxine to find out where Justin, Alex and Harper are, and Maxine does not say, so they force her to join a Pageant in order for her to tell them where they are. Things get bad at the angel club when Alex and Harper cannot fly, until Justin secretly pulls out his wand and gives Harper flying powers. Zeedrik still questions them by giving them a test to sing while playing the harp. Though Alex, Justin, and Harper fail to do so, they are accepted as "angels" until the key-chain of Ozzy Osbourne's star reverts to normal. Zeedrik believes they are really angels of darkness, causing everyone in the club to run off, even Rosie. Rosie comes back at the end of the episode to comfort Justin, but when they both look over the city, Rosie's wings are shown to be black, the color of an angel of darkness' wings, but Justin does not see because he is looking forward. Meanwhile, Maxine ends up winning the beauty pageant, making Jerry and Theresa celebrate.
Guest stars: Bailee Madison as Maxine, Leven Rambin as Rosie, Ransford Doherty as Zeedrik
Absent: Jake T. Austin as Max Russo
88
9 "Wizards vs. Angels" Victor Gonzalez Vince Cheung & Ben Montanio February 18, 2011 (2011-02-18) 409–410 5.1[8]
Rosie is an Angel of Darkness, and has been tricking Justin all along to make him evil. Alex finds out, with the help of Tina (a guardian angel in training trying to earn her wings) that Rosie is an Angel of Darkness. Justin crosses over to the dark side with Rosie, steals the "moral compass",and gives it to Gorog, so Gorog can turn the compass from good to bad, so that the world will be covered in darkness and every human being will be corrupted. Rosie tries to get Justin to run away and save him, because Gorog wants to destroy him, but Justin refuses to leave, stating that he is no longer a wizard but an Angel of Darkness and breaks his wand in half. Alex tries to convince Justin that he is a wizard, a good wizard and not an Angel of Darkness.
Meanwhile, Maxine is enrolled in Tribeca Prep, since she is participating in a "cousin exchange program." After her first day of school, Maxine laments that she has no friends,which leads Harper to insist Maxine have a slumber party (which is really what Harper wants because she has never had a slumber party), that eventually becomes a disaster. Tina reveals that Rosie was a good angel, and her teacher however, Gorog reached her before her transport arrived and corrupted her. Alex and Tina go to the Dark Realm to save Justin. Alex borrows a pair of wings from the guardian angels. Alex takes the Moral Compass and tries to turn it to good but Justin stops her and then Rosie used her good angel side and they fly up and when they land, Justin turns the compass to good. Tina and Alex take it and run. When Rosie and Justin kiss, Rosie turns into a good angel (with white wings), and Justin loses the dark wings.
Guest stars: Bill Chott as Mr. Laritate, Bailee Madison as Maxine, Leven Rambin as Rosie, John Rubinstein as Gorog, China McClain as Tina, Amy Tolsky as Florence
Note: This is a one-hour special.
Absent: Jake T. Austin as Max Russo
89
10 "Back To Max" Guy Distad Todd J. Greenwald March 11, 2011 (2011-03-11) 411 3.7[9]
Justin invites Professor Crumbs to check on his delinquent wizards class, to see how their wizard training is progressing. During the conversation, Maxine interrupts, causing Alex and Justin to panic since they do not know how to explain "Maxine", and they try to find a way to turn Maxine back to Max. Meanwhile, Harper takes a role in the school's "Spirit of America" play, only to be replaced by Maxine.
Guest stars: Bill Chott as Mr. Laritate, Ian Abercrombie as Professor Crumbs, Bailee Madison as Maxine, Cameron Sanders as Nelvis, LJ Benet as Little Crumbs, Jackie Evancho as Choir Girl
Note: Jake T. Austin returns as Max near the end of the episode. Bailee Madison marks her final appearance as Maxine in this episode.
90
11 "Zeke Finds Out" David DeLuise Peter Dirksen April 8, 2011 (2011-04-08) 412 3.0[10]
When Alex gets bored of Zeke's failing magic tricks, she decides to use magic to make Zeke's tricks come true. Everything goes downhill when Zeke tells Harper he believes he is a wizard and is now booking a magic act at the sub station for a kid's birthday party. Since Justin and Harper are tired of Alex ruining things all the time, they decide to leave everything up to her. Harper, not wanting to let Zeke make a fool of himself, tells Alex to tell Zeke the truth about wizards, but she is reluctant to, as exposing wizardry to another mortal could get her kicked out of the wizard competition forever if anyone finds out. Zeke goes on with his belief that he is a "wizard", but he finds out Harper is keeping a secret from him so he breaks up with her. Alex realizes what a mess she created and on the day of Zeke's magic act, she makes Harper disappear before she can expose wizardry to Zeke, which freaks him out. The Russos really are in deep waters when Zeke is going to saw Max in half with a real saw for his next act, so Justin takes matters into his own hands and freezes everyone except for himself and Zeke. Justin tells Zeke that he is a wizard, not Zeke, and that he did everything. Still not believing him, he flashes Zeke into their lair and unveils the secret to him. They go back outside and tell Harper and Alex who are fighting, that Zeke now knows about the existence of wizards, but he promises he will never tell anyone. Zeke and Harper reconcile their relationship and Alex and Harper apologize and make up with each other.
Guest stars: Dan Benson as Zeke, Maurice G. Smith as Big Mitch
Absent: Maria Canals Barrera as Theresa Russo, David DeLuise as Jerry Russo
91
12 "Magic Unmasked" David DeLuise Justin Varava May 13, 2011 (2011-05-13) 413 2.7[11]
When a former legendary Luchador "Muy Macho" visits the Sub Station, Alex finds out that she was the reason why he quit lucha libre (wrestling), so she tries to make it up to him by arranging a lucha libre match with him and Jerry to restore his honor. Meanwhile, Zeke asks too many questions about wizardry, so Justin offers to grant him one magical wish if he promised he would stop questioning him about magic. Unfortunately, Zeke's wish is to defeat Muy Macho in the match. Max pretends to like Talia's hobbies, but does not enjoy them.
Guest stars: Dan Benson as Zeke, Valente Rodriguez as Muy Macho, McKaley Miller as Talia
92
13 "Meet the Werewolves" Victor Gonzalez David Henrie June 17, 2011 (2011-06-17) 415 4.0[12]
When Alex asks Mason if she can meet his parents, Mason shows his fake parents and she finds out soon after. She gets upset at Mason and demands him to take her to his real parents. Mason takes her to the Autumn Moon Feast (werewolf holiday) to meet his parents. Soon after that Alex finds out he told his parents that she is a werewolf and is frustrated. She uses a spell to change herself and Harper into werewolves. She tries to be the worst werewolf possible in front of Mason's parents during the feast. In the end Mason's parents like her as a werewolf and she says to him that they do not know the real her. She begins to leave and he says that he truly loves Alex to his parents and that she is a wizard. She changes back to a wizard and Mason turns back to human form. After the parents find out they try to eat her and Mason and Alex make a near escape. Meanwhile Max makes his parents' food taste like kid food in order to make it taste good. Afterwards Jerry and Theresa eat it, and as a result they act like little kids. Justin thinks he will have to fix it but Max comments on how he does not need help, as he will be the future family wizard. Max uses another spell on cookies to make them older, but they turn into teenagers. Finally, Justin uses a spell on a pizza to turn them back into their regular selves.
Special guest star: Gregg Sulkin as Mason
Guest stars: Harry Van Gorkum as Grant Greybeck, Robin Riker as Linda Greybeck, Marianne Muellerleile as Molly, Eric Zuckerman as Bill
93
14 "Beast Tamer" Victor Gonzalez Gigi McCreery & Perry Rein June 24, 2011 (2011-06-24) 416 4.0[13]
When Alex, Justin and Max win four tickets to the "Beast Bowl", the tickets are delivered by Beast Tamer Chase Riprock, who begins flirting with Alex and invites the group for a pre-bowl tour. Alex invites Mason to go with them but he says he cannot. During the tour, despite Chase's warnings, Justin attempts to tame the beast so that Max can have his photo taken with the beast, but both are caught and banned from the event. Chase tries to kiss Alex but she rejects him and returns to the mortal world where she finds Mason coming out a hardware store. Mason is evasive about his plans, which involve making an anniversary present for Alex, so Alex returns to the Beast Bowl. Harper tells Mason that Chase likes Alex and urges him to surprise her with the gift at the Beast Bowl. Meanwhile, Justin and Max return to the Beast Bowl disguised as beast taming clowns where they allow the beast to escape and snatch Alex who throws the whip to Chase. Chase tames the beast who drops Alex and Mason is able to reveal his gift, which is a sculpture of himself and Alex. Alex and Mason leave together, with the sculpture.
Special guest star: Gregg Sulkin as Mason
Guest star: Nick Roux as Chase
Absent: Maria Canals Barrera as Theresa Russo, David DeLuise as Jerry Russo
94
15 "Wizard of the Year" Victor Gonzalez Richard Goodman July 8, 2011 (2011-07-08) 417 3.6[14]
Alex has been crowned Wizard of the Year after saving the world from dark angels, as well as being reinstated in the Wizard Competition, and a banquet honoring her achievement is hosted. With paparazzi in tow, Chase Riprock visits the lair to congratulate Alex. As he leaves, Keith Keith hounds them about being in a romantic relationship, to which Alex states she already has a boyfriend. Later, Mason and Alex watch his gossip segment, and to their horror, Keith Keith confirms that Chase and Alex are dating. For Alex winning Wizard of the Year, the Russo family must record a holographic video congratulating Alex. However, much to Justin's displeasure, Justin's video instead only contains him complaining about Alex. The night of the awards banquet, Mason stands Alex up, leaving her devastated. At the banquet, Chancellor TootieTootie tells Justin that his display of affection and pride for Alex may reinstate him into the competition, causing Justin to be frantic and do everything within his power to destroy the tape. Chase purposely invites himself to sit at the Russo's table. However, Mason shows up late and sees Alex and Chase flirting together. A short battle ensues between Mason and Chase. Alex soon breaks up the fight, and is forced to choose either Mason or Chase. Appalled by both of their behaviors that evening, Alex chooses neither and breaks up with Mason.
Special guest star: Gregg Sulkin as Mason
Guest stars: Andy Kindler as Chancellor Tootietootie, Nick Roux as Chase, Justin Guarini as Keith Keith
95
16 "Misfortune at the Beach" Jody Margolin Hahn Vince Cheung & Ben Montanio July 24, 2011 (2011-07-24) 420 3.5[15]
The Russos head to the beach on an extremely hot day, and Harper hopes to enjoy reading her book while at the beach. The Russos come across Zelzar, a fortune-telling machine. Jerry warns the kids about Zelzar – he is from the wizard world, and a wizard's fortune really comes true. After Max and Justin receive good fortunes, Alex decides to get a fortune despite her father's warning. However, her fortune says, "Say good-bye to your life." Alex thinks nothing of it and proceeds to enjoy the day at the beach, but comes close to life-threatening situations multiple times. Alex, Justin, Max, and Harper make a compromise with Zelzar – if they can extract him from the machine and let him enjoy a day at the beach, he will take back Alex's fortune. Max replaces Zelzar, and Justin is forced to drive the beach-goers away from the machine (as Max gives out silly fortunes about his new facial hair); meanwhile, the girls help Zelzar fancy his day at the beach. In the end, Zelzar reveals that while he cannot take away Alex's fortune, he can give it to the next person. The next person happens to be a little girl, who gets Alex's fortune. However, it is revealed that a man from Random Prize Giveaway shows up, saying: "Say good-bye to your life because we're randomly giving you one million dollars!"
Guest stars: Michael Carbonaro as Zelzar, John J. York as Game Show Host
96
17 "Wizards vs. Asteroid" Victor Gonzalez Peter Dirksen August 19, 2011 (2011-08-19) 418 3.6[16]
When it is announced that a huge asteroid is hurtling towards the earth, the Russos decide to hide in the wizard world, but Alex, Justin, and Max change their minds and go into space to destroy the asteroid. Meanwhile, Alex finds out that she is not graduating high school, but when a small part of the asteroid hits the school, she gets a chance to graduate.
Guest stars: Dan Benson as Zeke, Bill Chott as Mr. Laritate, Kristina Hayes as Reporter
97
18 "Justin's Back In" Guy Distad Todd J. Greenwald August 26, 2011 (2011-08-26) 419 3.2[17]
Justin's class of delinquent wizards has completed their studies, which means they are eligible to rejoin WizTech if they all pass their final evaluation. When they all fail, Alex suspects something is not right. The truth soon uncovered – the class had actually passed, but the historian who checked the exams was revealed to be evil, and had lied about the exam scores. He tries to attack Justin's class, so Justin must stop the historian, and save Alex. but one of the students in the class is able to stop him by pulling the most powerful wand in the wizard world out of a crystal ball and using it. This means that he is actually the descendant of a famous wizard who had previously been thought to have no living descendants. Justin's class is revealed to have passed the final exam, so they are readmitted into WizTech and Justin is officially back in the family wizard competition. Meanwhile, Jerry and Theresa realize that they never saved any of Max's childhood accomplishments, so they try to recreate them with the help of Harper. During the credits, it is revealed that Max had kept his favorite memories all along.
Special guest star: Tim Conway as Cragmont
Guest stars: Ian Abercrombie as Professor Crumbs, Frank Pacheco as Felix, Cameron Sanders as Nelvis
98
19 "Alex the Puppetmaster" Victor Gonzalez Gigi McCreery & Perry Rein September 16, 2011 (2011-09-16) 421 3.0[18]
Alex and Harper decide to do a puppet show to raise money for a new apartment and Zeke and Justin help them. But Alex forgets to write the lines for the show. Harper gets mad and decides to do a show of her own and makes her puppets act like the way Alex treats her. Alex makes Justin and Zeke puppets for her show and steals Harper's crowd which makes Harper upset. Then Alex apologizes to Harper using the puppets. Meanwhile, Talia's parents meet Theresa and Jerry for the first time, but it does not go well. Justin puts a spell on Talia's parents to forget they ever meet Theresa and Jerry. They meet again, but this time they end up watching a 16-hour play together.
Special guest star: Joely Fisher as Meg Robinson
Guest stars: Dan Benson as Zeke, James Urbaniak as Rob Robinson, McKaley Miller as Talia
99
20 "My Two Harpers" Victor Gonzalez Manny Basanese September 30, 2011 (2011-09-30) 422 3.0[19]
Harper and Zeke spend so much time together that Alex decides to make a Harper-clone. Justin comes with lots of different ideas to save money in the sub-shop and Max starts a fast-food restaurant in the wizard world.
Guest star: Dan Benson as Zeke
Absent: Maria Canals Barrera as Theresa Russo
100
21 "Wizards of Apartment 13B" Guy Distad Justin Varava October 7, 2011 (2011-10-07) 423 3.5[20]
Alex and Harper receive a flyer for a hotel. They meet the hotel's owner, Dexter, who sells them Apartment 13B, which belongs to a floor for non-humans. They rent it, but Harper is forced to use a training wand that can only open things. Later at their apartment, they realize Mason lives on the floor. Mason will stop at nothing to win Alex back; Alex tells him she does not want a boyfriend, but Mason is relentless. That night, Alex and Harper throw a party, where the whole floor comes, including Felix. Mason goes to the party and uses Harper's wand to open Alex's heart. However, she flirts with an ugly giant. Mason tries again, but makes Alex opens her heart to Felix. Meanwhile, Theresa and Jerry trick Justin into going to Alex's apartment to drive him out of the house. When Justin arrives, he fixes Mason's mistakes by resetting Harper's wand and it is revealed that despite his actions, he misses Alex. Alex, freed from Mason's spell, is angry at Mason, and Mason, deflated, leaves. Outside their door, Dexter turns into Gorog when no one is looking. He wants revenge. Max appears in the apartment, and when Harper and Alex kick him out, he encounters Gorog, who gives him a flyer for a free camp. Max accepts.
Special guest star: Gregg Sulkin as Mason
Guest stars: John Rubinstein as Gorog, Frank Pacheco as Felix, Fred Stoller as Dexter, Christopher Douglas Reed as Ogre
Note: This is part 1 of a 4-part arc and also the 100th episode.
101
22 "Ghost Roommate" David DeLuise Richard Goodman October 14, 2011 (2011-10-14) 424 4.1[21]
Alex and Harper have trouble paying the apartment bills, so Dexter recommends getting a roommate. Alex and Harper find a wealthy ghost named Lucy, who they let move in. Meanwhile, Justin orders a robot to help Zeke at the sub station, as Justin is busy studying for the wizard competition. The robot is lost in transit, but Dexter (Gorog in disguise) makes an evil robot to spy on Justin to pass information to Gorog. While Zeke and the robot are working, the robot asks him about Justin and the wizard competition, which confuses Zeke because no one had talked about it in front of the robot. Later that night, Lucy starts crying and explains that her boyfriend Donny had disappeared sixty years prior in a plane accident. Alex tries to set Lucy up with Justin, but he makes matters worse. Later, Lucy meets Mason and they go out on a long date, which makes Alex jealous. Meanwhile, the robot again asks Zeke about the wizard world and Zeke realizes that the robot might have a secret agenda. He tells Justin, who simply does not believe him and is ignorant of the situation because of his intensive studying. Because of her jealousy, Alex helps Lucy locate Donny, who had been stranded on an island in the Bermuda Triangle. They soon reconnect, but not after Alex realizes that she cannot get back home, due to heavy magnetic currents interfering with her magic. Mason goes to save Alex after he finds out that she had left for the Bermuda Triangle. The robot attacks Justin and Zeke after they find him scanning the spell book. Mason and Alex manage to get off of the island using the Bermuda shorts given to them by Justin. The robot is shown giving Gorog the spell he needed that he got from the Russos.
Special guest star: Gregg Sulkin as Mason
Guest stars: Dan Benson as Zeke, Fred Stoller as Dexter, Josh Sussman as Hugh Normous, Linsey Godfrey as Lucy, Travis Caldwell as Donny, Michael Carbonaro as Robot
Note: This is part 2 of a 4-part arc.
Absent: Jake T. Austin as Max Russo, Maria Canals Barrera as Theresa Russo, David DeLuise as Jerry Russo
102
23 "Get Along, Little Zombie" Victor Gonzalez Peter Dirksen October 21, 2011 (2011-10-21) 425 3.4[22]
Alex and Harper are going to their apartment when they run into Mr. Laritate, who also lives in the hotel. Felix tells Justin he broke his wand and Justin informs him that it's fake, because he saw batteries in it. He concludes that someone stole Felix's wand. Dexter is showing a zombie to the hall for magical creatures while he introduces them to Alex and Harper. Mason, who will stubbornly not stop asking Alex on a date, meets them in the elevator. When Alex ignores him, Mason messes with the buttons so he can spend more time with her and they land on the second floor. Justin tells Jerry that Felix lost his wand and Jerry tells them to use the abracadoobler wand app and Felix realizes that his wand is around the area. Meanwhile, because Mason messed with the buttons, all the humans have discovered the mysterious thirteenth floor. Alex lies and tells the humans that they accidentally got into a secret open house floor for the people in the hotel. Mr. Laritate, after all the other humans left, discovers the thirteenth floor too and sees Alex, Harper, and Mason. Mr. Laritate sees the zombie, Alex explains this is a haunted house, but Mr. Laritate does not believe them. The zombie bites Mr. Laritate and turns him into a zombie. They take him to their apartment while Alex looks for a spell to turn Mr. Laritate human again. Mr. Laritate runs away and Alex, Harper, and Mason suspect he went to the substation. Professor Crumbs questions Felix, who reveals the 13th floor to them, and Crumbs denies the existence of a "13th floor", so they go to investigate. At Waverly Place they're throwing a festival while Alex tells Jerry what happened. Alex and Mason, trying to sneak the zombie into the substation, are forced into dance. They then, after Harper causes a distraction, take Laritate to the substation and give him a medicine from the wizard world that turns Laritate human. He remembers nothing and goes outside to dance. Alex kisses him on the cheek, and Mason suggests they just be friends. Alex gets back together with Mason. Crumbs tells Felix the floor should not exist. Harper, Mason, and Alex return to the thirteenth floor. Justin tells them that the floor does not exist. Crumbs thinks that there is evil going on. Dexter then comes with dark angel wings and it is revealed he stole Felix's his wand. Dexter tricks Felix into turning to the dark side in return for the wand. Felix casts a spell that traps them all on the floor. Back at Waverly Place, Mr. Laritate is dancing while Jerry is selling chili, when Mr. Laritate gets one and gets water to get "the burn" out of his mouth.
Special guest star: Gregg Sulkin as Mason
Guest stars: Bill Chott as Mr. Laritate, Ian Abercrombie as Professor Crumbs, Frank Pacheco as Felix, Fred Stoller as Dexter, Regan Burns as Everett, Jane Carr as Martha St. Claire
Note: This is part 3 of a 4-part arc.
Absent: Jake T. Austin as Max Russo, Maria Canals Barrera as Theresa Russo
103
24 "Wizards vs. Everything" Victor Gonzalez Gigi McCreery & Perry Rein October 28, 2011 (2011-10-28) 426 3.4[23]
The wizards of 13th floor come out and Alex explains Dexter's evil. Dexter reveals himself as Gorog, and that he is trying to rebuild his army of darkness. Felix uses a spell that makes all the wizards from the 13th floor go with them, so they can make them all evil, all except Alex, Justin, and Harper, who are left behind. A trashcan tells them to go through it, however Alex ends up in the room again. Justin realizes only mortals can go through it. Alex convinces Harper into going through it, Harper then arrives in the wizard lair. Gorog takes the kidnapped wizards to his evil lair, where he plans to make them evil. He tricks Hugh Normous into becoming one of the evil wizards in his army. Professor Crumbs fakes becoming evil when Gorog plans on making him evil. Harper contacts Max and tells him about Gorog. Max arrives and suggests they look for spells in the wizard books. Gorog makes the wizard army to dig a hole to the atmosphere to the wizard world, so they can take over it. Gorog also tries to trick Mason into being one of the members in his army, but Mason refuses. Gorog tricks him into joining, however. Gorog then makes Felix send a black whole to suck Alex and Justin in it. Gorog gives the kidnapped wizards their wands so they can take over the wizard world, but Crumbs refuses to let them. Felix then gets rid of Crumbs on Gorog's order. The black hole nearly sucks Alex and Justin when Crumbs arrives at the wizard lair. Max suggests they put a black hole in the wizard lair. Max goes in and rescues Alex and Justin. Crumbs tells them to use their magic to stop Gorog. They arrive at Gorog's lair and attempt to destroy him, but Mason tries to convince Alex to join them. Gorog also reveals Juliet (young again), Justin's ex-girlfriend, and she convinces Justin to join. Alex also surrenders, and Max is forced to as well, the three then use their combined magic to get rid of Gorog, and all the supernatural beings are freed from his influence. Juliet and Justin get back together. Alex tricks Harper into moving in the Russos' basement by making her think all the wizards and supernatural creatures, with no home, are going to stay.
Special guest stars: Gregg Sulkin as Mason, Bridgit Mendler as Juliet van Heusen
Guest stars: Ian Abercrombie as Professor Crumbs, John Rubinstein as Gorog, Frank Pacheco as Felix, Fred Stoller as Dexter, Josh Sussman as Hugh Normous, Christopher Douglas Reed as Ogre
Note: This is part 4 of a 4-part arc.
Absent: Maria Canals Barrera as Theresa Russo, David DeLuise as Jerry Russo
104
25 "Rock Around the Clock" Guy Distad Robert Boesel November 4, 2011 (2011-11-04) 414 3.8[24]
The current landlord of the Russo's building decides to sell the sub shop, evicting the Russos of the shop, as well as their apartment and lair, which contains their portal. Without the portal, the Russos will lose all contact with the Wizard world. So, the entire family (along with Harper) travel back to 1957 to stop Jerry's father (the previous owner of the shop) from selling the shop to the landlord, so that they do not get evicted. Jerry's father agrees not to sell the shop, and the Russos return to present day. However, they accidentally leave Harper behind when Harper is distracted by a woman with a poodle, and Harper suggests that the woman should put a picture of a poodle on her skirt, creating a poodle skirt, which were popular in the 1950s.
Back in present day, the Russos (who have not yet realized Harper's absence) find the sub shop obsolete, boarded up, and empty, with the subway car and the lair missing, too. The Russos realized that they have messed with the fabric of time, and something they did while time-traveling in 1957 must have created a ripple effect, and affected present day.
While Alex suggests that they go back to 1957 to find out what they did wrong, Justin denies this, saying they should not solve the problem by doing exactly what caused the problem, however Theresa states that they will have to go back, when she realizes that they left Harper in 1957. The Russos return to 1957, where Jerry's father reveals that he did not sell the restaurant to the landlord, however the restaurant failed to make enough business, and that he has been forced to close it. Justin realizes that when Jerry's father lost the restaurant, he moved out of the building and since their family no longer lived in the building, the lair disappeared in present day. The Russos decide just to find Harper and go back to present day, and discover that Harper enrolled at Tribeca Prep as soon as they forgot her in 1957, as Harper did not want to ruin her perfect attendance record. Justin, Alex, and Max go to Tribeca Prep to retrieve Harper, while Jerry and Theresa wait at the sub shop, however Harper decides to stay in the past, as she finds new popularity in 1957 that she does not experience in present day. While at Tribeca, Max introduces the high-five to several students. Alex realizes that if they make the sub shop the 1957 high school hangout, the sub shop will get better business and will not have to close. However, no one has any fun at the sub shop that night as the jukebox is broken. Just as everyone is about to leave, Max plugs his MP3 player into the jukebox and Harper uses her popularity to get the students dancing and having fun at the shop, and the business at the sub shop peaks. The Russos return to the present day, where the lair and the sub shop are back, and Jerry owns the entire building, while the landlord is now the owner of a Janitor service, instead of the building, and the high-five is now called a "Max". Alex then remembers that they forgot Harper back in 1957 and they go back and get her. (the Russos accidentally end up in 1977 twice in the episode, thanks to Justin)
Guest stars: Brendan Bradley as Hank, Carlo Michael Mancini as Lenny Hune
105
26 "Harperella" Victor Gonzalez Richard Goodman & Justin Varava November 18, 2011 (2011-11-18) 427 3.5[25]
The episode begins on Waverly Place where Harper is reading a storybook to a group of children when Alex pushes her away. Alex explains that it's a Wizard Storybook, a magical storybook that has the power of turning what the person reads real. Then Harper is teleported into the loft where Theresa, her evil (or "wicked" as she referred) stepmother calls her Harperella (a combination of Harper and Cinderella) and forces her to do the chores.
Then her evil stepbrothers, Justin and Max come down and give her laundry to her wash. Later Harper is washing the Waverly Substation when Alex appears, as she is Harper's fairy godmother. Alex explains to Harper that the fairy tale has to run as it's supposed to before things can go back to the way they were and then vanishes. Then Max comes in and says that the prince charming has decided to use the Substation to be the ballroom for the royal party. Harper says that she can go to the party but her stepfamily laughs at her. Back in the loft Harper summons Alex, she uses a spell to transform Harper's bookdress into a princess gown and glass bowls into glass slippers. They go down (through the door) into the street and Alex turns the hot dog stand into a carriage to take Harper to the party. There she dances with prince charming, Zeke. At the stroke of midnight she goes outside leaving her glass slipper behind.
Then, to both girls' shock, Justin, Max and Zeke (with pig noses) rush inside the substation being chased by the big, bad wolf, Mason. Alex realizes that some pages are missing and Cinderella and three little pigs stories were blended together. The pig-turned boys and Harper rush into the loft being chased by Mason. While Alex finds the pages Harper has to keep Mason from eating Zeke (who built the straw house), Alex eventually finds the book pages in a drawer along with other book pages. Alex tries a page from Max's favourite magic trick book then David Copperfield comes into the room and does some magic tricks which impresses Harper. But another page that Alex tried was from Justin's science book and a caveman appeared, but the caveman has a thing for Harper. So when Harper is impressed by the magic trick he is jealous and tries to attack David Copperfield. Alex finds the right pages and the story goes back to Cinderella. Zeke Charming comes in and Theresa tries to wear the slipper but fails. Then Harper tries it and fits. She and Zeke go back to the royal party where they dance and then the story ends and the world is returned to its normality. Last but not least, Harper was back in the real world and she lived happily ever after. Finally, Alex planned that Harper and Zeke dance because they were great when they danced in romance, so they practiced but they were really bad. The ball dance is turned into a clogging dance.
Special guest stars: David Copperfield as himself, Gregg Sulkin as Mason
Guest star: Dan Benson as Zeke
Absent: David DeLuise as Jerry Russo
106
27 "Who Will Be the Family Wizard"[26] Victor Gonzalez Vince Cheung & Ben Montanio (Part 1)
Todd J. Greenwald (Part 2) January 6, 2012 (2012-01-06) 428–429 9.8[27]
During a dinner that Alex made for the family, Professor Crumbs visits to reveal that with this selfless act, the Russo children can finally have their family wizard competition. Round one of the competition is a trivia round, in which questions related to magic are asked. During this round, Harper and Zeke appear. Zeke has accidentally smelled a purple substance in the lair that caused him to turn purple. This causes a griffin to kidnap him and Harper. Alex, Justin and Max use their three time-outs to go and rescue their friends. They make it back, only to discover that they have been gone too long and have been disqualified from the competition. They all return home, where the lair disappears and they all lose their magic, thus becoming mortals. Justin and Max begin to hate Alex because of her insistence on saving Zeke and Harper resulting in them losing. Convinced that the loss of their powers has ruined the family, Jerry decides to sell the sub shop. The kids go for a day without magic, during which, slowly gaining back trust in each other as they reopen and run the shop. Suddenly, they are returned to the area of the Wizard Competition, where the host reveals that the griffin attack (which was actually meant for Professor Crumbs) and the weeks they went without magic were tests to test their family bond. They enter the final round of the competition, a massive labyrinth. The first out of the maze will win. Justin makes it out first and is declared the Family Wizard. However, he decides he cannot accept this because Alex was about to get out first: Justin had been trapped by magical vines and Alex, near the exit, came back to help. Alex is thus declared the true family wizard. Professor Crumbs, proud of Justin's integrity in telling the truth, declares that he is going to retire as Headmaster of Wiz-Tech and declares Justin the new headmaster, granting him full wizard powers. Considering Max is the only Russo child that does not get powers or becomes a full wizard, Jerry thus decides to one day pass down the sub shop to Max, which he happily accepts. It ends with the Russo family hugging and gathering together with Alex stating that they are all finally happy at the same time.
Special guest stars: Gregg Sulkin as Mason, Bridgit Mendler as Juliet van Heusen
Guest stars: Dan Benson as Zeke, Ian Abercrombie as Professor Crumbs, Andy Kindler as Chancellor Tootietootie
Note: This is an hour long special.
References[edit]
Jump up ^ "Shows A-Z – wizards of waverly place on disney". the Futon Critic. Retrieved January 6, 2012.
Jump up ^ Seidman, Robert (November 15, 2010). "Friday Cable Ratings: Sanctuary Rises +Friday Night Smackdown!, Avalon High, NBA, Wizards of Waverly & More". TV by the Numbers. Retrieved November 15, 2010.
Jump up ^ Seidman, Robert (December 13, 2010). "Friday Cable Ratings: NBA Leads Night, Plus 'Conspiracy Theory, ' 'Gold Rush: Alaska, ' 'Sanctuary, ' 'Smackdown' & More". TV by the Numbers. Retrieved December 13, 2010.
Jump up ^ Seidman, Robert (January 10, 2011). "Friday Cable Ratings: Gold Rush Alaska, Suite Life on Deck, Wizards of Waverly, Merlin and More". TV by the Numbers. Retrieved January 10, 2011.
Jump up ^ Seidman, Robert (January 24, 2011). "Friday Cable Ratings: 'Gold Rush: Alaska, ' & NBA Lead Night +'Smackdown, ' 'Spartacus, ' 'Victorious, ' 'Merlin' & More". TV by the Numbers. Retrieved January 24, 2011.
Jump up ^ Seidman, Robert (February 7, 2011). "Friday Cable Ratings: 'Gold Rush: Alaska, ' 'Wizards of Waverly Place' Lead Night, 'Merlin' Down + 'Smackdown' & More". TV by the Numbers. Retrieved February 7, 2011.
Jump up ^ Cable ratings: Monday Night Football, RAW, White Collar and Monk top weekly cable chart Posted on November 3, 2009 by Robert Seidman
Jump up ^ Seidman, Robert (February 22, 2011). "Friday Cable Ratings: 'Gold Rush: Alaska' Ends Season on Top; 'Merlin' & 'Spartacus: Gods of The Arena' Rise + 'Wizards of Waverly' & More". TV by the Numbers. Retrieved March 11, 2011.
Jump up ^ Gorman, Bill (March 14, 2011). "Friday Cable Ratings: 'WWE Smackdown' Up, Leads Night + 'Flying Wild Alaska, ' 'Merlin' & More". TV by the Numbers. Retrieved March 19, 2011.
Jump up ^ "Friday Cable Ratings: 'Merlin' Dethrones 'Camelot'; Plus 'Friday Night Smackdown, ' 'Say Yes To The Dress' and More – Ratings | TVbytheNumbers". Tvbythenumbers.zap2it.com. Retrieved September 23, 2011.
Jump up ^ "Friday Cable Ratings: Thunder/Grizzlies Leads Night + 'American Restoration, ' 'Friday Night Smackdown!' and More – Ratings | TVbytheNumbers". Tvbythenumbers.zap2it.com. Retrieved September 23, 2011.
Jump up ^ Seidman, Robert (June 20, 2011). "Friday Cable Ratings: 'American Restoration' Leads Primetime Originals, 'Smackdown' Dips". TV by the Numbers. Retrieved June 20, 2011.
Jump up ^ Seidman, Robert (June 28, 2011). "Cable Top 25: 'BET Awards, ' 'True Blood, 'NASCAR' and 'Burn Notice' Top Weekly Cable Viewing". TV by the Numbers. Retrieved July 8, 2011.
Jump up ^ Seidman, Robert (July 11, 2011). "Friday Cable Ratings: More 'Torchwood: Miracle Day, ' + 'Friday Night Smackdown, ' 'Wizards of Waverly' & More". TV by the Numbers. Retrieved July 12, 2011.
Jump up ^ "Cable Top 25: 'Pawn Stars, ' 'The Closer, ' 'Rizzoli & Isles' Top Weekly Cable Viewing – Ratings | TVbytheNumbers". Tvbythenumbers.zap2it.com. July 26, 2011. Retrieved September 23, 2011.
Jump up ^ Seidman, Robert (August 22, 2011). "Friday Cable: 'Smackdown' Up, Tops Night; 'Haven, ' 'Thundercats' Steady + 'Wizards of Waverly Place' & More". TV by the Numbers. Retrieved August 22, 2011.
Jump up ^ Gorman, Bill (August 29, 2011). "Friday Cable: 'Smackdown' Tops Night; Hurricane Irene Boosts Weather Channel + 'Haven, ' 'Thundercats' & More". TV by the Numbers. Retrieved August 29, 2011.
Jump up ^ Seidman, Robert (September 19, 2011). "Updated Friday Cable Ratings: 'Storage Wars' Tops Primetime; 'Smackdown' Falls; 'Haven, ' 'Thundercats' Steady & More". TV by the Numbers. Retrieved September 23, 2011.
Jump up ^ Seidman, Robert (October 3, 2011). "Friday Cable: Rain-Shortened Yankees/Tigers Tops Night + 'Haven, ' 'Clone Wars, ' 'Smackdown!' & Much More". TV by the Numbers. Retrieved October 17, 2011.
Jump up ^ Gorman, Bill (October 10, 2011). "Friday Cable: Cardinals/Phillies Tops Night, Plus 'Smackdown!, ' 'Sanctuary' Premiere 'Jessie' & Much More". TV by the Numbers. Retrieved October 17, 2011.
Jump up ^ Seidman, Robert (October 17, 2011). "Friday Cable: NLCS Leads Night Plus 'Smackdown!, ' 'Sanctuary, ' 'Make Your Mark, ' 'Jessie' & More". TV by the Numbers. Retrieved October 17, 2011.
Jump up ^ Gorman, Bill (October 24, 2011). "Friday Cable Ratings: 'Smackdown!' Ties 'SpongeBob;' Plus 'Sanctuary,' 'Boss,' 'House Of Payne' & More". tvbythenumbers.zap2it.com. Retrieved October 30, 2011.
Jump up ^ http://tvbythenumbers.zap2it.com/2011/10/31/friday-cable-ratings-discoverys-gold-rush-tops-cable-friday-night-smackdown-sancturary-boss-more/109085/
Jump up ^ Seidman, Robert (November 7, 2011). "Friday Cable Ratings: Discovery's 'Gold Rush' Tops Cable + 'Friday Night Smackdown,' 'Sanctuary,' 'Boss' & More". TV by the Numbers. Retrieved November 7, 2011.
Jump up ^ Gorman, Bill (November 21, 2011). "Friday Cable Ratings: 'Gold Rush' Tops Cable + Okla. St./Iowa St., 'Friday Night Smackdown,' 'Sanctuary,' 'Flying Wild Alaska' & More". TV by the Numbers. Retrieved November 22, 2011.
Jump up ^ "Disney Channel and Disney Junior January 2012 Highlights". Disney Channel Media Net. January 4, 2012. p. 1. Archived from the original on February 6, 2012. Retrieved January 5, 2012.
Jump up ^ Seidman, Robert. "Friday Cable Ratings: 'Wizards of Waverly Place Finale,' 'Gold Rush' Lead + 'Jessie,' 'Smackdown!,' 'Merlin' & More". Tvbythenumbers.com. Retrieved January 9, 2012.
General references
"Shows A-Z – wizards of waverly place on disney". the Futon Critic. Retrieved March 13, 2011.
"Wizards of Waverly Place Season 4 episodes". TV Guide. Retrieved March 13, 2011.
"Wizards of Waverly Place: Episode Guide". MSN TV. Retrieved March 13, 2011.
External links[edit]
List of Wizards of Waverly Place season 4 episodes at TV.com
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Wizards of Waverly Place
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"Wizards on Deck with Hannah Montana"
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Wizards of Waverly Place: The Movie
The Wizards Return: Alex vs. Alex
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text:
Ear pain
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Ear pain
Synonyms
Otalgia, earache
Examination of the ear canal and eardrum
Classification and external resources
ICD-10
H92.0
ICD-9-CM
388.7
DiseasesDB
18027
MedlinePlus
003046
eMedicine
ent/199
Patient UK
Ear pain
[edit on Wikidata]
Ear pain, also known as earache or otalgia, is pain in the ear.[1][2] Primary ear pain is pain that originates from the ear. Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt.
Most causes of ear pain are non-life threatening.[3][4] Primary ear pain is more common than secondary ear pain[5], and it is often due to infection or injury.[3] The conditions that cause secondary (referred) ear pain are broad and range from temporomandibular joint syndrome to inflammation of the throat.[3]
In general, the reason for ear pain can be discovered by taking a thorough history of all symptoms and performing a physical examination, without need for imaging tools like a CT scan.[3] However, further testing may be needed if red flags are present like hearing loss, dizziness, ringing in the ear or unexpected weight loss.[6]
Management of ear pain depends on the cause. If there is a bacterial infection, antibiotics are sometimes recommended and over the counter pain medications can help control discomfort.[7] Some causes of ear pain require a procedure, either at the doctor’s office or in surgery.[7][8][9]
One review found 83% of children had at least one episode of a middle ear infection by 3 years of age.[10]
Contents
[hide]
1 Signs and symptoms
2 Pathophysiology
2.1 Primary ear pain
2.2 Secondary ear pain
3 Causes
3.1 External ear
3.1.1 Otitis externa
3.1.2 Mechanical obstruction
3.1.3 Less common causes
3.2 Middle and inner ear
3.2.1 Acute otitis media
3.2.2 Trauma
3.3 Secondary (referred) ear pain
4 Diagnostic approach
5 Management
5.1 Antibiotics
5.2 Procedures
5.3 Other management
6 Epidemiology
7 History
8 Society and culture
9 Research
10 References
11 External links
Signs and symptoms[edit]
Ear pain can present in one or both ears. It may or may not be accompanied by other symptoms such as fever, sensation of the world spinning, ear itchiness, or a sense of fullness in the ear. The pain may or may not worsen with chewing.[3] The pain may also be continuous or intermittent.[11]
Ear pain due to an infection is the most common in children and can occur in babies.[10] Adults may need further evaluation if they have hearing loss, dizziness or ringing in the ear.[6] Addition red flags include diabetes, a weakened immune system, swelling seen on the outer ear, or swelling along the jaw.[12]
Pathophysiology[edit]
Primary ear pain[edit]
The ear can be anatomically divided into the external ear, the external auditory canal, the middle ear, and the inner ear.[13] These three are indistinguishable in terms of the pain experienced.[2]
Secondary ear pain[edit]
Referred Otalgia
Many different nerves provide sensation to the various parts of the ear, including cranial nerves V (trigeminal), VII (facial), IX (glossopharyngeal), and X (vagus), and the great auricular nerve (cervical nerves C2-C3).[13][14] These nerves also supply other parts of the body, from the mouth to the chest and abdomen. Irritation of these nerves in another part of the body has the potential to produce pain in the ear.[13] This is called referred pain. Irritation of the trigeminal nerve (cranial nerve V) is the most common cause of referred ear pain.[3]
Causes[edit]
Ear pain has a variety of causes, the majority of which are not life-threatening.[3][4] Ear pain can originate from a part of the ear itself, known as primary ear pain, or from an anatomic structure outside the ear that is perceived as pain within the ear, known as secondary ear pain.[3] Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt. Primary ear pain is more common in children, whereas secondary (referred) pain is more common in adults.[15]
Primary ear pain is most commonly caused by infection or injury to one of the parts of the ear.[3]
External ear[edit]
Many conditions involving the external ear will be visible to the naked eye. Because the external ear is the most exposed portion of the ear, it is vulnerable to trauma or environmental exposures.[16] Blunt trauma, such as a blow to the ear, can result in a hematoma, or collection of blood between the cartilage and perichondrium of the ear. This type of injury is particularly common in contact sports such as wrestling and boxing.[17] Environmental injuries include sunburn, frostbite, or contact dermatitis.[16]
Less common causes of external ear pain include:[16][18]
Auricular Cellulitis: a superficial infection of the ear that may be precipitated by trauma, an insect bite, or ear piercing
Perichondritis: infection of the perichondrium, or fascia surrounding the ear cartilage, which can develop as a complication of untreated auricular cellulitis. It is important to identify and treat perichondritis with antibiotics to avoid permanent ear deformities.
Relapsing polychondritis: a systemic inflammatory condition involving cartilage in many parts of the body, but often including the cartilage of both ears. The severity and prognosis of the disease varies widely.[19]
Otitis externa[edit]
Otitis externa, also known as “swimmer's’ ear, ” is a cellulitis of the external ear canal. In North America, 98% of cases are caused by bacteria, and the most common causative organisms are Pseudomonas and Staph aureus.[20] Risk factors include exposure to excessive moisture (e.g. from swimming or a warm climate) and disruption of the protective cerumen barrier, which can result from aggressive ear cleaning or placing objects in the ear.[21]
Malignant otitis externa is a rare and potentially life-threatening complication of otitis externa in which the infection spreads from the ear canal into the surrounding skull base, hence becoming an osteomyelitis.[18] It occurs largely in diabetic patients.[22] It is very rare in children, though can be seen in immunocompromised children and adults.[21] Pseudomonas is the most common causative organism.[22] The pain tends to be more severe than in uncomplicated otitis externa, and laboratory studies often reveal elevated inflammatory markers (ESR and/or CRP). The infection may extend to cranial nerves, or rarely to the meninges or brain.[22] Examination of the ear canal may reveal granulation tissue in the inferior canal. It is treated with several weeks of IV and oral antibiotics, usually fluoroquinolones.[22]
Mechanical obstruction[edit]
Earwax impaction: results in 12 million medical visits annually in the United States.[23] Cerumen impaction may cause ear pain, but it can also prevent thorough examination of the ear and identification of an alternate source of pain.
Foreign body: commonly include insects or small objects like beads[5]
Less common causes[edit]
Herpes zoster: varicella zoster virus can reactivate in an area that includes the ear. Reactivation can produce pain and visible vesicles within the ear canal and, when combined with facial paralysis due to facial nerve involvement, is called Ramsay Hunt syndrome.[24]
Tumors: the most common ear canal tumor is squamous cell carcinoma. Symptoms can resemble those of otitis externa, and cancer should be considered if the symptoms are not improving on appropriate treatment.[18]
Middle and inner ear[edit]
Acute otitis media[edit]
Otitis media
Acute otitis media is an infection of the middle ear. More than 80% of children experience at least one episode of otitis media by age 3 years.[25] Acute otitis media is also most common in these first 3 years of life, though older children may also experience it.[21] The most common causative bacteria are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.[21] Otitis media often occurs with or following cold symptoms.[16] The diagnosis is made by the combination of symptoms and examination of the tympanic membrane for redness, bulging, and/or a middle ear effusion (collection of fluid within the middle ear).[5]
Complications of otitis media include hearing loss, facial nerve paralysis, or extension of infection to surrounding anatomic structures, including:[26]
Mastoiditis: infection of the air cells in the mastoid process, the area of the skull located right behind the ear[21]
Petrositis: infection of the petrous portion of the temporal bone
Labyrinthitis
Meningitis
Subdural abscess
Brain abscess
Trauma[edit]
Barotrauma: results from changes in atmospheric pressure that occur when descending in a plane or deep diving. As atmospheric pressure increases with descent, the eustachian tube collapses due to pressure within the middle ear being less than the external pressure, which causes pain. In severe cases, middle ear hemorrhage or tympanic membrane rupture can result.[18]
Tympanic membrane rupture: disruption of the eardrum. This can be caused by a blow to the ear, blast injury, barotrauma, or direct penetration of the tympanic membrane by an object entering the ear.[5]
Secondary (referred) ear pain[edit]
A variety of conditions can cause irritation of one of the nerves that provides sensation to the ear.
Conditions causing irritation the trigeminal nerve (cranial nerve V):[3]
Temporomandibular joint syndrome: inflammation or abnormal movements of the joint between the jaw and skull. These disorders are most common in women of childbearing age, and are uncommon in children younger than 10 years old.[27][28][16]
Myofascial pain syndrome: pain in the muscles involved in chewing. There may be certain parts of the muscles or tendons (connective tissue connecting the muscles to bones) that are especially painful when pressed[27]
Trigeminal neuralgia: attacks of shooting pain down the face that may be triggered by touching the face or temperature changes[29]
Dental pain from cavities or an abscess
Oral cavity carcinoma
Conditions causing irritation of the facial nerve (cranial nerve VII) or glossopharyngeal nerve (cranial nerve IX):[3]
Tonsillitis: infection/inflammation of the tonsils
Post-tonsillectomy: pain following surgical removal of the tonsils
Pharyngitis: infection/inflammation of the throat
Sinusitis
Parotitis: inflammation of the parotid gland, the salivary gland right in front of the ear
Carcinoma of the oropharynx (base of tongue, soft palate, pharyngeal wall, tonsils)
Conditions causing irritation of the vagus nerve (cranial nerve X):[3]
GERD
Myocardial ischemia (inadequate oxygen supply to the heart muscle)
Conditions causing irritation of cervical nerves C2-C3:[3][16]
Cervical spine trauma, arthritis (joint inflammation), or tumor
Temporal arteritis: an autoimmune disorder leading to inflammation of the temporal artery, a large artery in the head. This condition tends to occur in adults older than 50. [18]
Diagnostic approach[edit]
Acute ear pain decision tree[4][8][9]
Chronic ear pain decision tree[4][8][9]
While some disorders may require specific imaging or testing, most etiologies of ear pain are diagnosed clinically. Because the differential for ear pain is so broad, there is no consensus on the best diagnostic framework to use. One approach is to differentiate by time course, as primary causes of ear pain are typically more acute in nature, while secondary causes of ear pain are more chronic.
Acute causes may be further distinguished by the presence of fever (indicating an underlying infection) or the absence of fever (suggesting a structural problem, such as such as trauma or other injury to the ear). Etiologies leading to chronic pain may be broken down by the presence or absence of worrisome clinical features, also known as red flags.
One red flag is the presence of one or multiple risk factors including smoking, heavy alcohol use (greater than 3.5 drinks per day), diabetes, coronary artery disease, and older age (greater than 50).[3] These factors increase the risk of having a serious cause of ear pain, like cancer or a serious infection. In particular, second hand smoke may increase risk of acute otitis media in children.[30] In addition, swimming is the most significant risk factor for otitis externae, though other risk factors include high humidity in the ear canal, eczema and/or ear trauma.[31]
If red flags are present it may be necessary to do additional workup such as a CT scan or biopsy to rule out a more dangerous diagnosis. Such diagnoses include malignant (or necrotizing) otitis externa, mastoiditis, temporal arteritis, and cancer. It is important to note that while the presence of a red flag does raise suspicion for one of these four disease, it does not guarantee a diagnosis as any one symptom can be seen in a variety of situations. For example jaw claudication can be seen in temporal arteritis, but also in TMJ dysfunction.[4]
If there are no red flags other sources of referred ear pain become more likely and are reasonable to pursue.
Infectious causes
Diagnosis
Features[4][8][9]
Acute Otitis Media History of URI within 10 days Child pulling on ear Severe pain; feels deep inside the ear.
Fever Hearing loss Pain may disrupt sleep
Perforated tympanic membrane Discharge followed by pain improvement
Mastoiditis* Children History of URI >10 days Recent history of URI or ear infection
Fevers/chills May see signs of otitis media on exam Pain is located behind the ear with postauricular (i.e. near mastoid process) swelling*
Diagnose with CT
Chronic suppurative otitis media Conductive hearing loss Relapsing/remitting or chronic discharge May see perforation of tympanic membrane or cholesteatoma on exam
Serous otitis media
(otitis media with effusion)
No signs of infection Prominent hearing loss May have history of URI or acute otitis media)
Otitis externa Swimming Psoriasis Seborrheic dermatitis
Q-tips in the ear Bilateral pain Scaling
Itching Pain exacerbated when ear is pulled May see granulation tissue in canal on exam
Necrotizing/malignant
otitis externa*
Diabetes Immuno-compromised Constant pain with increasing severity at night*
Purulent discharge* Pain out of proportion to exam findings* Biopsy granulation tissue for culture
Chondritis vs perichondritis Recent ear trauma (i.e. ear piercing) External ear appears inflamed Chondritis more likely than perichondritis if ear shape is distorted
Referred causes
Diagnosis
Features[4][8][9]
GERD Bilateral pain
Neuralgia Pain described as tingling/sharp/burning sensation; episodes can start with light touch
Malignancy* Weight loss*
Arthritis of the neck Pain exacerbated by neck movement
Eagle syndrome Swallowing exacerbates pain
Infected 3rd molar Extreme food temperatures exacerbate pain
Temporal arteritis* Patient age > 50* Chewing exacerbates pain*
TMJ dysfunction Patient grinds teeth Bilateral pain
Pain + crepitus with TMJ palpation Jaw clicking
*Indicates a "Can't Miss" diagnosis or a red flag.
Other causes
Diagnosis
Features[4][8][9]
Barotrauma Recent ear trauma Recent scuba diving or flying (+/- onset of pain coinciding with event) Hearing loss
Eustachian tube dysfunction Pain described as ear pressure or “plugged up” sensation in ears Unilateral hearing loss Crackling/gurgling sounds in ear
History of seasonal allergies Poor light reflex and TM mobility Air-fluid levels present
Cerumen Impaction Q-tips in the ear Pain described as ear pressure or “plugged up” sensation in ears May need to remove any ear wax present to rule this out as the underlying etiology
Management[edit]
Management of ear pain depends on the underlying cause.
Antibiotics[edit]
While not all causes of ear pain are treated with antibiotics, those caused by bacterial infections of the ear are usually treated with antibiotics known to cover the common bacterial organisms for that type of infection. Many bacterial ear infections are treated with cleaning of the area, topical or systemic antibiotics, and oral analgesics for comfort.[7][32][9] Some types of bacterial ear infections can benefit from warm compresses included in the treatment.[7] Some of the causes of ear pain that are typically treated with either a topical or systemic antibiotic include:
Uncomplicated acute bacterial otitis externa (AOE).[7][32] For symptoms that are not responsive to treatment within 10 days, a physician should evaluate for necrotizing external otitis.[7]
Acute otitis media (AOM) self-resolves within 24-48 hours in 80% of cases.[32] If it does not self-resolve, AOM thought to be caused by bacteria is treated with systemic antibiotics. If symptoms do not respond to a week of treatment, a physician should evaluate for mastoiditis.[32]
Acute folliculitis.[32]
Auricular cellulitis.[9]
Suppurative otitis media.[8] There is also a risk for tympanic membrane rupture.[8]
Perichondritis. An otorhinolaryngologist should also evaluate it and if a foreign body is present in the cartilage, this foreign body should be removed.[32][8] If there is cartilage involvement, then more advance care with hospitalization is needed.[8]
Sinusitis can cause secondary ear pain. Treating the underlying sinusitis will treat the ear pain. (See sinusitis.)[32]
Some bacterial infections may require a more advanced treatment with evaluation by otorhinolaryngology, IV antibiotics, and hospital admission.
Necrotizing external otitis is potentially fatal and should be evaluated by an otorhinolaryngologist with admission to the hospital and IV antibiotics.[32][8](See otitis externa.)
Acute mastoiditis is treated with admission to the hospital, otorhinolaryngology consultation and empiric IV antibiotics.[32][7][8][9] Cases with intracranial involvement are treated with a mastoidectomy with myringotomy.[32][9]
Chondritis.[32][8]
Procedures[edit]
Some causes of ear pain require procedural management alone, by a health professional, or in addition to antibiotic therapy.
Keratosis obturans is treated with removal of impacted desquamated keratin debris in the ear canal.[32]
Chronic perichondritis and chondritis that continues to be symptomatic despite appropriate antibiotic management may require surgical debridement.[32] Surgical drainage could be required.[9]
Bullous myringitis leads to the development of bullae on the tympanic membrane that can be punctured to give pain relief.[32]
Foreign body in the ear canal can cause pain and be treated with careful removal.[8]
Infected sebaceous cyst is treated with incision and drainage of the cysts, oral antibiotics and otorhinolaryngology assessment.[8]
Other management[edit]
Given the variety of causes of ear pain, some causes require treatment other than antibiotics and procedures.
Relapsing polychondritis is an autoimmune disease treated with immunomodulating medications (medications that help modulate the immune system).[32]
Temporomandibular joint dysfunction can lead to secondary ear pain and can be initially treated with a soft food diet, NSAIDs, application of a heat pack, massage of local area, and a referral to a dentist.[32][18]
Myofascial pain syndromes are initially treated with NSAIDs and physical therapy. Local anesthetic injection into the muscle trigger point can be considered in severe cases.[32]
Glossopharyngeal neuralgia is treated with carbamazepine.[18]
Epidemiology[edit]
2/3 of people presenting with ear pain were diagnosed with some sort of primary otalgia and 1/3 were diagnosed with some sort secondary otalgia.[5]
A common cause of primary otalgia is ear infection called otitis media, meaning an infection behind the eardrum.[3] The peak age for children to get acute otitis media is ages 6-24 months. One review paper wrote that 83% of children had at least one episode of acute otitis media by 3 years of age.[10] World wide, there are 709 millions cases of acute otitis media every year.[33] Hearing loss globally due to ear infection is estimated to be 30 people in every 10,0000.[33] Around the world there is around 21,000 to 28,000 deaths due to complications from ear infections.[33] These complications include brain abscesses and meningitis.
Otitis externae peaks at age 7-12 years of age and around 10% of people has had it at least once in their lives.[10]
Cerumen impaction occurs in 1 out of every 10 children, 1 in every 20 adults and 1 in every 3 elderly citizens.[10]
Barotrauma occurs around 1 in every 1000 people.[5]
Of people presenting with ear pain, only 3% was diagnosed with eustachian tube dysfunction.[3]
History[edit]
Not much was known about ear pain and acute otitis media before the 17th century. It was a common phenomenon with no treatment.[34] That changed when the otoscope was invented in the 1840s by Anton von Troeltsh in Germany.[34] Another shift came with the invention of antibiotics. Before antibiotics was introduced there use to be a high rate of ear infections spreading to the bone around the ear. Now it’s a rare complication.[5]
Society and culture[edit]
Professor Anton Friedrich von Tröltsch 1869 O. Roth, Inventer of the otoscope
There was previously a strong tradition of treating acute otitis media with amoxicillin.[5] One quote from the 1980s shows this sentiment by saying “any child with an earache has an acute amoxicillin deficiency”.[5] However, people started realizing that using antibiotics too much can cause bacteria to gain resistance.[35] Increasing resistance makes antibiotics less effective. The term antibiotic stewardship is then used to describe the systematic effort to educate antibiotic prescribers to only give these medications when they are warranted. In particular to children, most ear pain resolves by itself with no complications.[33] There are guidelines in place to help determine when antibiotics for ear pain are needed in children.
The ear itself played a role in treatment via acupuncture, also known as auriculotherapy. Acupuncture of the ear is used to fix an unbalance in the body. Such practices may have started as far back as the Stone Age. The first documentation of auriculohterapy in Europe was in the 1600s. One physician described stimulating (by burning or scarring) the ear to treat sciatic pain, while another physician applied it for toothache. Paul Nogier is known as the father of ear acupuncture for his theory that parts of the ear corresponds to other areas of the body in a reliable fashion.[36]
Research[edit]
There are currently studies going on delivering antibiotics directly into the middle ear.[33]
References[edit]
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^ Jump up to: a b c d e f g h Sullivan DJ (2012). "Chapter 17:Ear Pain". In Henderson MC, Tierney LM, Smetana GW. The Patient History: An Evidence-Based Approach to Differential Diagnosis (2 ed.). New York, NY: The McGraw-Hill Companies.
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^ Jump up to: a b "Position Statement: Red Flags-Warning of Ear Disease". American Academy of Otolaryngology-Head and Neck Surgery. 2014-03-20. Retrieved 2018-03-13.
^ Jump up to: a b c d e f g Coombs C (2016). "Chapter 118: Ear and Mastoid Disorders in Infants and Children". In Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide (8 ed.). New York, NY: McGraw-Hill Education. ISBN 978-0071794763.
^ Jump up to: a b c d e f g h i j k l m n o Stallard TC (2017). "Chapter 32: Emergency Disorders of the Ear, Nose, Sinuses, Oropharynx, & Mouth". In Stone CK, Humphries RL. CURRENT Diagnosis & Treatment: Emergency Medicine (8 ed.). New York, NY: McGraw-Hill Education.
^ Jump up to: a b c d e f g h i j k Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, eds. (2016). "Chapter 58: Sore Throat, Earache, and Upper Respiratory Symptoms". Harrison's Manual of Medicine (19th ed.). McGraw-Hill Education. ISBN 978-0071828529.
^ Jump up to: a b c d e Rosa-Olivares J, Porro A, Rodriguez-Varela M, Riefkohl G, Niroomand-Rad I (November 2015). "Otitis Media: To Treat, To Refer, To Do Nothing: A Review for the Practitioner". Pediatrics in Review. 36 (11): 480–6; quiz 487–8. doi:10.1542/pir.36-11-480. PMID 26527627.
Jump up ^ Harrison E, Cronin M (July 2016). "Otalgia". Australian Family Physician. 45 (7): 493–7. PMID 27610432.
Jump up ^ Tucci, Debara L. (October 2016). "Earache". Ear, Nose, and Throat Disorders - Merck Manuals Professional Edition.
^ Jump up to: a b c Morton DA, Foreman KB, Albertine KH (2011). "Chapter 19. Ear". The Big Picture: Gross Anatomy. New York, NY: The McGraw-Hill Companies. ISBN 978-0071476720.
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Jump up ^ Li, John (2017-09-21). "Otalgia: Background, Pathophysiology, Epidemiology". Medscape.
^ Jump up to: a b c d e f Greenes, David. "Evaluation of earache in children". www.uptodate.com. Retrieved 2018-03-14.
Jump up ^ Leybell, Inna (2017-06-20). "Auricular Hematoma Drainage: Overview, Indications, Contraindications". Medscape.
^ Jump up to: a b c d e f g Lustig LR, Schindler JS (2017). "Chapter 8: Ear, Nose, & Throat Disorders". In Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment 2018. New York, NY: McGraw-Hill Education.
Jump up ^ Compton, Nicholas. "Relapsing Polychondritis Clinical Presentation: History, Physical, Causes". emedicine.medscape.com. Retrieved 2018-03-14.
Jump up ^ Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, Huang WW, Haskell HW, Robertson PJ (February 2014). "Clinical practice guideline: acute otitis externa". Otolaryngology--Head and Neck Surgery. 150 (1 Suppl): S1–S24. doi:10.1177/0194599813517083. PMID 24491310.
^ Jump up to: a b c d e Yoon PJ, Scholes MA, Friedman NR (2016). "Chapter 18: Ear, Nose, & Throat". In Hay WW, Levin MJ, Deterding RR, Abzug MJ. CURRENT Diagnosis & Treatment Pediatrics (23rd ed.). New York, NY: McGraw-Hill Education. ISBN 978-0071848541.
^ Jump up to: a b c d Grandis, Jennifer; et al. (February 2018). "Malignant (necrotizing) otitis externa" . www.uptodate.com. Retrieved 2018-03-14.
Jump up ^ Schwartz S, et al. (January 2017). "Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary". Otolaryngology–Head and Neck Surgery. 156 (1): 14–29. doi:10.1177/0194599816678832  .
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^ Jump up to: a b Goddard, Greg (2012). "Chapter 26. Temporomandibular Disorders". In Lalwani, Anil K. CURRENT Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery (3 ed.). New York, NY: The McGraw-Hill Companies.
Jump up ^ Tsai, Vivian (2018-01-02). "Temporomandibular Joint Syndrome: Background, Pathophysiology, Epidemiology". Medscape.
Jump up ^ Singh, Manish (2017-09-26). "Trigeminal Neuralgia: Practice Essentials, Background, Anatomy". Medscape.
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Jump up ^ Schaefer P, Baugh RF (December 2012). "Acute otitis externa: an update". American Family Physician. 86 (11): 1055–61. PMID 23198673.
^ Jump up to: a b c d e f g h i j k l m n o p q Neilan RE, Roland PS (September 2010). "Otalgia". The Medical Clinics of North America. 94 (5): 961–71. doi:10.1016/j.mcna.2010.05.004. PMID 20736106.
^ Jump up to: a b c d e Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (January 2014). "Update on otitis media - prevention and treatment". Infection and Drug Resistance. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142  . PMID 24453496.
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Jump up ^ Fleming, Alexander (25 June 1945). "The Penicillin Finder Assays its Future". The New York Times: 21.
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External links[edit]
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