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.
|Dental inflammation and infection
|Trauma and foreign bodies
|Temporomandibular joint disorders
|Head and neck cancer
Refer to the diagram below when thinking about your management of the case.