Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Otalgia is defined as ear pain. It is one of the complaints which may occur at any age. The
etiology of the pain may be in the ear, structures around the ear or other head and neck structures
This is caused by the complex nervous connections in the head and neck areas, the ear, the
pharynx and the nose. objective: since understanding the etiologies of referred otalgia can help in
the assessment and treatment of the disease, this research was conducted to identify the
etiologies of referred otalgia in patients visiting the ENT Clinic in mosul , Iraq
OBJECTIVE:
Since understanding the etiologies of referred otalgia can help in the assessment and treatment of
the disease, this research was conducted to identify the etiologies of referred otalgia in patients
visiting the ENT Clinic in Mosul , Iraq. We have reviewed the complex neuroanatomic basis of
nonotogenic ear pain
PATIENT AND METHODS:
A prospective study of 211 patients with ear pain. During a 12 month period from 2010
to2011,two hundred and eleven patients with otalgia were studied, they were attendant of the
outpatient clinic of ENT department in Al-Jumhury Teaching Hospital. Patient age ,gender
,occupation, residence were recorded in a representative questionnaire form. All patients had a
normal otologic examination and diagnosed with causes for referred otalgia were categorized
according to distribution of cranial nerve, gender and age.
RESULTS:
The majority of causes of otalgia (64%)were due to referred pain, while only(35.5)of causes
were due to ear leasions. significantly referred pain affected patient above the age of 15yr more
than those below the age of 15yr .The most common cause for referred otalgia in Females was
Temporomandibular joint (TMJ) dysfunction (29.2%);while cervical spine lesion was
commonest in male. The trigeminal nerve was the major cranial nerve causing referred pain in
both gender (53.7)
CONCLUSION:
Since the early 1900s, referred otalgia has been a well-documented phenomenon in the ear, nose,
and throat (ENT) and neurosurgical literature. However, Essentially any pathology residing
within the sensory net of cranial nerves V, VII, IX, and X and upper cervical nerves C2 and C3
can potentially cause referred otalgia. A thorough understanding of the various sensorineural
pathways that dually innervate the ear and other sites and ongoing dialogue with our clinical
colleagues, will ensure that patients with referred otalgia will receive the best care in the head
and neck.