Otalgia Symptom Causes ENT











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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 (ear pain) is a common presentation in the primary care setting with many diverse causes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. Examination of the ear usually reveals abnormal findings in patients with primary otalgia. Pain that originates outside the ear is called secondary otalgia, and the etiology can be difficult to establish because of the complex innervation of the ear. The most common causes of secondary otalgia include temporomandibular joint syndrome and dental infections. Primary otalgia is more common in children, whereas secondary otalgia is more common in adults. History and physical examination usually lead to the underlying cause; however, if the diagnosis is not immediately clear, a trial of symptomatic treatment, imaging studies, and consultation may be reasonable options. Otalgia may be the only presenting symptom in several serious conditions, such as temporal arteritis and malignant neoplasms. • Patients with otalgia (ear pain) commonly present to their primary care physician. Pain that originates from the ear is known as primary otalgia, whereas pain that originates outside the ear is secondary otalgia. A comprehensive history and physical examination are essential to determine the etiology of primary or secondary otalgia. • Primary otalgia is more common in children, whereas secondary otalgia is more common in adults.1,2 The etiology of primary otalgia, which is usually identified on examination of the ear, is typically otitis externa or otitis media.3 The etiology of secondary otalgia is more complex because the nerves innervating the ear have a shared distribution to include the head, neck, chest, and abdomen2,4 (Figure 1). The ear is innervated by several sensory nerves. The auricle is affected by cranial nerves V, VII, X, C2, and C3; the external auditory meatus and canal by cranial nerves V, VII, and X; the tympanic membrane by cranial nerves VII, IX, and X; and the middle ear by cranial nerves V, VII, and IX. Irritation of any portion of these nerves can result in otalgia. • #ear #ent #mbbs #knowinganatomy • #otalgia #symptoms

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