Etiology of Referred Otalgia

Abstract

ABSTRACT: BACKGROUND:Otalgia is defined as ear pain. It is one of the complaints which may occur at any age. The etiology of the pain may be in the ear, structures around the ear or other head and neck structures This is caused by the complex nervous connections in the head and neck areas, the ear, thepharynx and the nose. objective: since understanding the etiologies of referred otalgia can help inthe assessment and treatment of the disease, this research was conducted to identify theetiologies of referred otalgia in patients visiting the ENT Clinic in mosul , IraqOBJECTIVE: Since understanding the etiologies of referred otalgia can help in the assessment and treatment ofthe disease, this research was conducted to identify the etiologies of referred otalgia in patientsvisiting the ENT Clinic in Mosul , Iraq. We have reviewed the complex neuroanatomic basis ofnonotogenic ear pain PATIENT AND METHODS: A prospective study of 211 patients with ear pain. During a 12 month period from 2010to2011,two hundred and eleven patients with otalgia were studied, they were attendant of theoutpatient clinic of ENT department in Al-Jumhury Teaching Hospital. Patient age ,gender,occupation, residence were recorded in a representative questionnaire form. All patients had anormal otologic examination and diagnosed with causes for referred otalgia were categorizedaccording to distribution of cranial nerve, gender and age.RESULTS: The majority of causes of otalgia (64%)were due to referred pain, while only(35.5)of causeswere due to ear leasions. significantly referred pain affected patient above the age of 15yr morethan those below the age of 15yr .The most common cause for referred otalgia in Females wasTemporomandibular joint (TMJ) dysfunction (29.2%);while cervical spine lesion wascommonest in male. The trigeminal nerve was the major cranial nerve causing referred pain inboth gender (53.7) CONCLUSION: Since the early 1900s, referred otalgia has been a well-documented phenomenon in the ear, nose,and throat (ENT) and neurosurgical literature. However, Essentially any pathology residingwithin the sensory net of cranial nerves V, VII, IX, and X and upper cervical nerves C2 and C3can potentially cause referred otalgia. A thorough understanding of the various sensorineuralpathways that dually innervate the ear and other sites and ongoing dialogue with our clinicalcolleagues, will ensure that patients with referred otalgia will receive the best care in the headand neck.