Otalgia is common and indiscriminate, affecting persons of all ages with nearly a 100% lifetime prevalence. The otalgia was characterized by a continuous, deep, stabbing pain radiating from the right side of the. The causes for referred otalgia were categorized into group i. Although the causes are frequently otological in origin, one needs to be aware of the nonotological pathologies that can result in referred pain to the ear. The frequency of referred otalgia was significantly higher in. In the absence of primary otologic pathology, referred pain from a head and. A comprehensive history and physical examination are essential to determine the cause of primary otalgia or secondary otalgia referred ear pain. Post tonsillectomy pain always radiates to the ipsilateral ear. Unerupted wisdom teeth, erupting teeth, and malocclusion can likewise cause referred otalgia. Most children with otogenic otalgia were diagnosed with acute otitis media aom. With the recent and rapid progression of ct and mr imaging technology, radiologists have played an increasing role in solving this potentially difficult diagnostic dilemma. Otalgia is a common symptom in children presenting to general practitioners, paediatricians and otorhinolaryngologists. Pdf secondary otalgia in an adult population yrsa bell. Diagnosis and management of otalgia in children adc.
Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic. Typical sources of primary otalgia are external otitis, otitis media, mastoiditis, andauricular infections. 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. The radiologic approach to a patient with otalgia relies on the physical examination.
Secondary otalgia in an adult population otolaryngology jama. Check the full list of possible causes and conditions now. The rich sensory innervation of the ear derives from four cranial nerves and two cervical nerves that also supply other areas in the head, neck, thorax, and abdomen. Oct 01, 2009 self does not result in referred otalgia but is an indicator of periodontal or periapical infection that can produce referred otalgia. Primary ear pain is pain that originates from the ear. Many patients in primary care present with ear pain otalgia. Otalgia is very common, and when the cause of ear pain is not identified on otoscopy and physical examination, crosssectional imaging is routinely used to evaluate for potential sources of referred ear pain secondary otalgia.
Aural symptoms in patients referred for temporomandibular paindysfunction. Pain that originates from the ear is known as primary otalgia, whereas pain that originates outside the ear is secondary otalgia referred ear pain 1. Otalgia, especially referred otalgia, can be a diagnostic challenge. Inflammatory and infective conditions of the middle ear are by far the predominant causes of primary otalgia in children. Specialist referral could be made if there are complications of primary otalgia or if a.
May 01, 2014 otalgia is a common presenting complaint to ear nose and throat departments. Similarly, at this platform we share dutt and sundaram pdf free download handwritten notes pdf in hindienglish and dutt and sundaram free pdf study material for sarkari exam jobs. Cervical spine causes for referred otalgia james j. Ear pain, also known as earache, is pain in the ear.
Essentially any pathology residing within the sensory net of cranial nerves v, vii, ix, and x and the. A few other diagnoses should always be considered when dealing with otalgia. Patients complaining of otalgia, with risk factors for an. Apr 01, 2008 all patients had a normal otologic examination and diagnosed with unspecified otalgia. Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source.
Pain referred to the ear is a welldocumented phenomenon, which can be due to a multitude of disease processes. Unlimited viewing of the article pdf and any associated supplements and figures. Inflammatory and infective conditions of the middle ear are by far the predominant causes of primary otalgia in. Referred otalgia is a red flag symptom and can be a diagnostic challenge for clinicians and radiologists as the pathology may be occult. Otalgia types, pathophysiology, diagnostic evaluation. Pdf otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source. Common causes of primary otalgia include otitis media, external otitis, folliculitis, cerumen impaction, mastoiditis. Temporal arteritis, parotid neoplasms, and herpes zoster are all treatable diseases in which early diagnosis may be. The sensory innervation of the ear involves six nerves. The aetiology of otalgia can be divided into otological and referred depending on its underlying pathology.
Cranial nerve vii produces referred otalgia via the auricular branch of the facial nerve. Pdf a study of the etiology of referred otalgia researchgate. Jan 27, 2018 applying the ts of referred otalgia to a cohort of 226 patients. A case of zoster sine herpete misdiagnosed as referred otalgia. Thyroid function and erythrocyte sedimentation rate esr. Frequently, the workup suggests that otalgia may be a problem of dental origin. Etiology of referred otalgia world health organization. Secondary referred otalgia is referred to the ear from disease in structures remote from the ear. The radiology of referred otalgia american journal of. Primary and referred otalgia pathways of the facial nerve vii. Otogenic otalgia was more common in men, whereas referred otalgia was more common in women. May 01, 2020 clinical differences in types of otalgia.
Etiology of primary otalgia pinna external auditory canal. Acute temporomandibular joint paindysfunction syndrome. If ear pain arises from pathologies in surrounding structures it is called as secondary or referred otalgia. If auroscopy is unremarkable, consider referred causes of pain and. Many cases of referred otalgia are secondary to benign processes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. Click the download file button to get the compressed file. Among all causes of referred otalgia, dental pathology, which transmits referred otalgia via a branch of the trigeminal nerve, is the most common source of nonotogenic pain. It can be broadly divided into primary otalgia, which includes the diseases occurring largely within the ear, or secondary otalgia, which is pain referred to the ear by travelling along cranial nerves that supply both the ear and referred region.
Pdf the radiology of referred otalgia researchgate. Ear pain can be caused by disease in the external, middle or inner ear, but the three are indistinguishable in terms of the pain experienced. In the study by leonetti et al, 2 the most common cause of referred otalgia in patients whose chief complaint was otalgia with a normalappearing ear was dental 74%. Applying the ts of referred otalgia to a cohort of 226 patients. Pain relief following cervical spine physical therapy cspt was assessed. A complete blood count may indicate an occult infection. All you need to do to compress pdf document is to drag and drop the original file into the opened tab of your browser, set the pdf compression level and click compress. Examination auroscopy looking for causes eg, otitis media, cerumen. The mechanisms of referred otalgia are incompletely understood and challenging to. Many other structures in the head, neck and thorax share a common neuronal pathway with the ear, and these tissues represent the possible sites of disease in the cases of referred otalgia. Referred otalgia is from pain that originates from outside the ear. Objectivepresent experience in diagnosis and treatment for referred otalgia secondary to cervical spine degenerative disease csdd. Innervation of the ear structures is complex, involving multiple upper cervical, lower cranial, and peripheral nerves, which transit and innervate a large. May 01, 2020 once determined, most causes of referred otalgia can be readily treated.
Pdf clinical differences in types of otalgia researchgate. Therefore, ear pain may be due to inflammatory conditions of the skin of the outer ear, the ear canal, or. Primary ear pain is more common than secondary ear pain, and it is often due to infection or injury. It is most frequently caused by infectious diseases in the ear, such as otitis. Secondary otalgia may arise from diseases in the paranasal sinuses, nose, and pharynx or, frequently, from temporomandibular disorder tmd.
Treatment varies for the different etiologies of otalgia. Kuttila and clinical patients whose chief complaint was otal the prevalences of the. Request pdf differential diagnosis of otalgia background. Ear pain may also be the first sign of a head and neck malignancy. Secondary ear pain is a type of referred pain, meaning that the source of the. This article aims to provide a systematic and evidence. May 10, 2007 the ear receives an extensive sensory innervation arising from six nerve roots. Ear pain is a diagnostic problem when examination of the ear. Secondary otalgia in an adult population otolaryngology.
Pdf otalgia is one of the complaints which may occur at any age. Otalgia otalgia is a common presenting symptom to the ent clinic the aetiology of otalgia can be divided into otological and non otological 50% of cases non otological. Consequently, the differential diagnosis is extensive and varied. This material may not otherwise be downloaded, copied, printed, stored. Referred otalgia does not have a distinct otologic etiology and is also termed secondary, or nonotogenic. Sources of referred otalgia, grouped according to cranial and cervical nerves. This article focuses on the radiological approach to referred otalgia. Click below to download shakespeares full macbeth play in pdf format for free, to read or share.
The actual enumeration shall be made within three years after. Jan 21, 2019 otalgia is aching or pain in the ear and causes can be primary, relating to the ear itself, or referred from sources outside the ear. The previous sentence in parentheses was modified by the 14th amendment, section 2. Use antivirals if the causative agent is suspected to be viral, such as in cases associated with herpes zoster or shingles.
It is the overlap in distribution of the 9th and 10th cranial nerves that establishes the anatomic basis for referred otalgia in diseases of the oral cavity, oropharynx, and larynx. In secondary or referred otalgia, the ear examination is usually normal, and the pain. Primary otalgia is pain with an etiology in the ear. Applying the ts of referred otalgia to a cohort of 226. The origins of referred otalgia may be as remote as the cranial cavity and thorax. Referred otalgia is a challenging symptom, with the burden on the physician to identify the source.
The otalgia had been present for 3 months, and sudden hearing loss on the right side had occurred 5 days before referral. Kamal abouelhamd md professor in ent alahsa college of medicine king faisal university 042812 abouelhamd 2. Chickenpox acute otalgia, fever, vesicular skin rash nonspecific varying cluster of infections summary most common causes of otalgia will be a local cause, otitis media or externa, but it is important to be suspicious of referred pain to the ear which may indicate a more serious pathology. Pain to the ear can be referred from disorders affecting other portions of head and neck. Pain that originates within the ear is primary otalgia. Above all, ssc, upsc books notes datt and sundaram indian economy.
Otalgia is a common presenting symptom to the ent clinic. He returns three days later with persistent fever and headache. The most common etiology of referred otalgia was dental problems 62. Pdf candy will start processing your file right away. Report otalgia patofisiologi please fill this form, we will try to respond as soon as possible.
Only by careful patient history and physical examination can all. Use antibiotics in treating various types of infections eg, tonsillitis, pharyngitis, sinusitis. Pain resulting from a pathologic condition of the ear is called primary otalgia. The severity of the symptoms do not correlate with the gravity of. Only by careful patient history and physical examination can all causes in this extensive differential diagnosis be excluded. The ear receives an extensive sensory innervation arising from six nerve roots.
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