Skip to Main Content

Key Features

  • Earache can be caused by a variety of otologic problems, but external otitis and acute otitis media are most the common (see Otitis, External and Otitis Media, Acute)

Clinical Findings

  • Pain out of proportion to the physical findings may be due to herpes zoster oticus, especially when vesicles appear in the ear canal or concha

  • Persistent pain and discharge from the ear suggest osteomyelitis of the skull base or cancer

  • Nonotologic causes of otalgia are numerous

    • The sensory innervation of the ear is derived from the trigeminal, facial, glossopharyngeal, vagal, and upper cervical nerves

    • Because of this rich innervation, referred otalgia is quite frequent

  • Temporomandibular joint dysfunction

    • Common cause of referred ear pain

    • Pain is exacerbated by chewing or psychogenic grinding of the teeth (bruxism) and may be associated with dental malocclusion

  • Repeated episodes of severe lancinating otalgia may occur in glossopharyngeal neuralgia

  • Infections and neoplasia that involve the oropharynx, hypopharynx, and larynx frequently cause otalgia

Diagnosis

  • Pneumatic otoscopy should differentiate between external otitis and acute otitis media (see Otitis, External and Otitis Media, Acute)

Treatment

  • For temporomandibular joint dysfunction

    • Soft diet

    • Local heat to the masticatory muscles

    • Massage

    • Nonsteroidal anti-inflammatory medications

    • Dental referral

  • For glossopharyngeal neuralgia, carbamazepine 100–300 mg orally every 8 hours often confers substantial symptomatic relief

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.