To present a case referred to our clinic with severe right ear pain but without any abnormal finding during otological examination and diagnosed as myocardial infarction and also to draw attention to otalgia which can occur secondary to myocardial infarction. Lymphadenitis parotitis swelling over angle mandible tmj dysfunction fairly common 10 years facial nerve palsy oropharyngeal infections sinusitis referred pain v trigeminal nerve ear drainage. 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. 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.
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. May 01, 2020 once determined, most causes of referred otalgia can be readily treated. When referred otalgia is present, the ear examination is typically normal. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The authors propose a unified schema and outline potential areas of nervous system error giving rise to pain in a clinically normal ear. Pain that originates within the ear is primary otalgia. Use antibiotics in treating various types of infections eg, tonsillitis, pharyngitis, sinusitis. Many cases of referred otalgia are secondary to benign processes. It occurs in up to 50% of adult patients who consult a general physician for otalgia1 and because of the nature of the ears sensory innervations, a wide variety of disorders can produce referred otalgia. To meet eligibility for the trial, the children were required to have received at least two doses of pneumococcal conjugate vaccine and to have aom that was diagnosed based on one of three criteria. 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.
Secondary otalgia in an adult population otolaryngology. The ear canal is heavily innervated, and the skin lining the canal lies directly against the bone without an intervening subcutaneous layer. Sep 15, 2016 otalgia is a very common presentation in general practice and most cases are due to infections and are treated appropriately. 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. Sometimes the paindiscomfort is due to a nonbiologic trigger, like cell phone use read more about this here. Typical sources of primary otalgia are external otitis, otitis media, mastoiditis, andauricular infections. Ear pain may be caused by a problem inside the ear, such as an outer or middle ear infection, or from a problem outside but near the ear, such as sinusitis, temporomandibular joint syndrome, or a dental infection. Pdf the radiology of referred otalgia researchgate.
Otalgia symptoms, causes, diagnosis, and treatment information for otalgia earache with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis. Many patients in primary care present with ear pain otalgia. In secondary or referred otalgia, the ear examination is usually normal, and the pain may be. Otalgia, ear pain, can be a consequence of otology disease primary or otogenyc otalgia or can arise from pathologic processes and structures far away from the ear secondary or referred otalgia. 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%. Indeed, this particular cause of otalgia is due to cranial nerve 5 that transmits pain involving the jaw to the ear itself. The second type is called referred otalgia, where the ear pain sensation originates from other parts of the body, excluding the ears. There are many other examples of nonear causes of otalgia. Primary ear pain is more common than secondary ear pain. Hidden earaches the ten ts of referred ear pain hc. Referred otalgia of tonsillar origin was noted in 4731. Injectable 1% xylocaine can be used to identify neuromuscular trigger points and can be useful in the diagnosis of myalgias and neuralgias.
Otalgia or ear pain is one of the most common complaints in the pediatric age group presenting to the primary care or emergency room. Referred otalgia referred otalgia is the sensation of ear pain originating from a source outside the ear the general ear region is sensorily innervated via four cranial nerves and two spinal segments. The radiologic approach to a patient with otalgia relies on the physical examination. The frequency with which the various head and neck sites were involved in referred otalgia has been given in tableii. The etiology of the pain may be in the ear, structures around the ear or other head. Otalgia, unspecified ear ear pain, referred from another site. Otalgia definition of otalgia by the free dictionary. Otalgia, especially referred otalgia, can be a diagnostic challenge. The most common etiology of referred otalgia was dental problems 62. The severity of the symptoms do not correlate with the gravity of. Otalgia symptoms, causes, diagnosis, and treatment information for otalgia earache with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and prognosis.
Cervical spine causes for referred otalgia james j. Secondary referred otalgia is referred to the ear from disease in structures remote from the ear. The causes for referred otalgia were categorized into group i. 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. Although many entities can cause referred otalgia, their relationship to ear pain must be identified. The etiology of the pain may be in the ear, structures around the. At the same time, referred otalgia is frequently missed and this diagnosis is seldom made because it largely falls outside the standard medical paradigm. Feustel, phd otolaryngologyhead and neck surgery 2008 8.
Once determined, most causes of referred otalgia can be readily treated. Primary otalgia is ear pain that originates inside the ear, whereas referred otalgia is ear pain that. When primary otalgia is present, an ear examination typically shows some abnormality of the outer or middle ear. 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. The radiology of referred otalgia american journal of. Treatment varies for the different etiologies of otalgia. Etiology of primary otalgia pinna external auditory. A categorical discussion of the workup, treatment, prognosis. Approximately 4% of general practitioner gp encounters are solely for ears. Referred otalgia is pain that originates outside of the ear. At the same time, referred otalgia is frequently missed and this diagnosis is seldom made because it largely falls. Collectively, dental disorders are the most common causes of secondary otalgia presenting to the ent clinic, and may account for up to 50 per cent of referred otalgia. Kamal abouelhamd md professor in ent alahsa college of medicine king faisal university 042812 abouelhamd 2. Secondary or referred otalgia can represent a diagnostic challenge to the otolaryngologist.
Otalgia, or pain localised to the ear, is a common symptom seen in general practice, emergency departments and otolaryngology clinics. Essentially any pathology residing within the sensory net of cranial nerves. Otalgia ear pain is a common presentation in the primary care setting with many diverse causes. Otalgia definition, icd 9 code, treatment, symptoms. Reflex otalgia definition of reflex otalgia by medical.
Use the force to ace this quiz on the words of the day from may 4 to may 10. Oe scant and thicker in consistency om copious, may be bloody, serosang, purulent or thin and watery. Pain referred to the ear is a welldocumented phenomenon, which can be due to a multitude of disease processes. A complete medical history and full head and neck examination usually is enough to diagnose the cause of otalgia. Primary otalgia is a symptom of another ear disease condition like external otitis, viral myringitis, acute otitis media and mastoiditis. An 87yearold female admitted with right ear pain lasting for nearly 12 hours and sweating on the head. Aural symptoms in patients referred for temporomandibular paindysfunction. Ear pain, also known as earache, is pain in the ear. Additional symptoms affecting the ear include ringing in the ear tinnitus and ear pain otalgia. Otalgia article about otalgia by the free dictionary.
Otalgia is one of the complaints which may occur at any age. Primary being caused by diseases of the ear and referred being caused by diseases elsewhere. A study of the etiology of referred otalgia article pdf available in iranian journal of otorhinolaryngology 2469. Pdf on mar 1, 2008, m a siddiq and others published otalgia find, read and cite all the research you need on researchgate. Use antivirals if the causative agent is suspected to be viral, such as in cases associated with herpes zoster or shingles. Referred or secondary otalgia is a challenging symptom, with the burden on the physician to identify the source.
These cases may be referred to as zoster sine herpete. In adults, referred ear pain is more often the culprit and with few exceptions the eardrum is normal in appearance. Otalgia is a very common presentation in general practice and most cases are due to infections and are treated appropriately. Secondary otalgia may arise from diseases in the paranasal sinuses, nose, and pharynx or, frequently, from temporomandibular disorder tmd. Primary ear pain is pain that originates from the ear. Referred otalgia accounts for up to 50% of all complaints of ear pain. Hidden earaches the ten ts of referred ear pain hc smart. Acute temporomandibular joint paindysfunction syndrome. If the otoscopic findings are abnormal, the computed tomographic ct or.
Pdf a study of the etiology of referred otalgia researchgate. 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 diffused sensory innervation of the ear is susceptible to such disorders. Many disorders produce referred ear pain because of infections, tumors and trauma. Pdf otalgia is one of the complaints which may occur at any age. Essentially any pathology residing within the sensory net of cranial nerves v, vii, ix, and x and the. Pdf otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a. And best of all its ad free, so sign up now and start using at home or in the classroom. 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. Otalgia may or may not be associated with balance disorders and a reduction in hearing. All patients had a normal otologic examination and diagnosed with unspecified otalgia.
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