Otalgia

Question 1

What is the classification of otalgia? (2)

Answer 1

Primary otalgia- pinna, external auditory canal, middle ear

Secondary- referred from other structures

Question 2

Which nerves can refer pain to the ear? (3)

Answer 2

C2/C3 spinal nerves and facial nerve (pinna)

Trigeminal (V3) and vagus nerves (external auditory canal, tympanic membrane)

Glossopharyngeal nerve (middle ear)

Question 3

Causes of C2/C3 referred pain? (2)

Answer 3

Arthritis, cervical spondylosis

Question 4

Causes of trigeminal nerve referred pain? (2)

Answer 4

Dental disease

TMJ dysfunction

Question 5

Causes of glossopharyngeal nerve referred pain? (3)

Answer 5

Any infection of the oropharynx e.g. pharyngitis, tonsilitis, quinsy
Tongue base tumour
Pain post-tonsillectomy

Question 6

Causes of vagus nerve referred pain?

Answer 6

Carcinomas of larynx and hypopharynx

Question 7

The referred otalgia of pharyngitis is mediated by which nerve?

Answer 7

Glossopharyngeal

Question 8

An acoustic neuroma can impact on the function of which nerves? (3)

Answer 8

Trigeminal nerve (corneal reflex, facial sensation)
Facial nerve (facial palsy)
Vestibulocochlear (hearing and balance impaired, tinnitus)

Question 9

Bilateral acoustic neuromas are seen in which condition?

Answer 9

Neurofibromatosis type 2

Question 10

Investigation of choice in suspected acoustic neuroma?

Answer 10

MRI of the cerebellopontine angle