Section 1 : About this Course
Section 2 : A respiratory Appointment
Section 3 : An appointment for Ear, Nose, and Throat
Section 4 : It may be nothing but lets check that chest pain out
HALF WAY THERE
Section 5 : A typical day at work
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Characteristics of differential diagnoses – ear pain

To understand otalgia and its causes and complications, a brief appreciation of anatomy is required.

Otalgia is frequently seen in general practice. 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 which supply both the ear and referred region. The causes of secondary otalgia may require more extensive examination and investigation to define the aetiology.

The aetiology of otalgia can be broadly divided into primary and secondary causes (Table 2).

Primary causes are those which originate in the ear and are a direct cause of pain through stimulation of nociceptor fibres. Secondary causes are those which the patient feels have originated from the ear, but in fact are referred from other sources and require a higher index of suspicion to determine the precise aetiology. Additionally, primary otalgia seems to be more common in children and secondary otalgia more common in adults.

Earache

Primary otalgiaSecondary otalgia
InfectionDental inflammation and infection
Trauma and foreign bodiesTemporomandibular joint disorders
Impacted cerumenTrigeminal neuralgia
Otologic neoplasmsHead and neck cancer
Temporal arteritis

Refer to the diagram below when thinking about your management of the case.