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Otalgia

January 22, 2011 by staff 

Otalgia, Earache is pain in the ears or earache. Primary otalgia is an earache that originated in the ear. Referred otalgia is an earache that comes from outside the ear.

Earache is not always associated with ear disease. It can be caused by several conditions, such as impacted teeth, sinus disease, inflamed tonsils, infections of the nose and pharynx, throat cancer, and sometimes as an aura before a migraine sensory.

A disease of the external ear, middle, or internal, can cause ear pain but the three are indistinguishable in terms of pain
The neuroanatomical basis of referred otalgia is based in one of the five major nerve pathways [1] the ear region is generally sensory ennervated four cranial nerves and two vertebral segments. Thus, pathology in other “non-ear body parts ennervated by these neural pathways can” see “the ear pain. These channels generally are:

Via the trigeminal nerve [cranial nerve V]. Rarely, trigeminal neuralgia can cause an earache. Carcinoma of the oral cavity can also cause ear pain in this way.
Via facial nerve [cranial nerve VII]. This may come from the teeth (usually the upper molars, when it will be worse when drinking cold liquids), the temporomandibular joint (due to its close relationship with the ear canal), or parotid gland.
Via glossopharyngeal nerve [cranial nerve IX]. This comes in the oropharynx and may be due to pharyngitis or tonsillitis, or cancer of the oropharynx (base of tongue, soft palate, pharyngeal wall, tonsils).
Via vagus nerve [cranial nerve X]. This may result from laryngopharynx in carcinoma of the area that, or the esophagus in GERD.
Through the second and third spinal segments, C2 and C3.
In adults with chronic pain of the ear, another normal ear examination, the diagnosis is carcinoma of the head and neck until proven otherwise. However, some patients have a “psychogenic earache, and no cause of pain in the ears can be found (which suggests a psychosomatic origin). The patient in such cases should be kept under observation with periodic reassessment.

It is usually possible to establish the cause of ear pain on the basis of history. It is important to exclude cancer, where appropriate, particularly with unilateral otalgia in an adult who uses tobacco or alcohol [2]. Often, migraines are caused by middle ear infections that can be easily treated with antibiotics. Often with a warm washcloth can temporarily relieve ear pain.
It is not unusual for an ear infection to develop in early childhood. Although it is not contagious, ear infections can occur as side effects of infectious diseases, colds, cough, or eye diseases like conjunctivitis. [via wikipedia]

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