Reffered Otalgia

Question 1

What are the nerve innervations

Answer 1

Red - lesser occipital nerve (C2/C3)

Yellow - facial nerve (CN VII)

Purple - spinal nerves (C2/C3)

Green - auriculo-temporal branch of the trigmeninal nerve (CN V3)

Blue - auricular branch of the vagus nerve (CN X)

Question 2

What is the innervation of the internal side of the tympanic membrane?

Answer 2

tympanic branch of the glossopharyngeal nerve (CN IX)

Question 3

What pathology can cause otalgia via the auriculo temporal branch of the trigemnial nerve (CN V3)?

Answer 3

lower mandibular pathology - dental abscess, dental carries, impacted molar teeth

TMJ lesions

infection or inflammation of the anterior 2/3rds of the tongue - e.g. piercings

stress - tooth grinding

salivary gland disease - infection (e.g. mumps), stones, neoplasm

Question 4

What pathologies can cause otalgia via the facial nerve (CN VIII)?

Answer 4

geniculate herpes/Ramsay Hunt syndrome

spheniod or ethmoidal sinus pathology - e.g. infection or neoplasm

nasal pathology - e.g. foreign bodies

Question 5

What pathologies can cause otalgia via the tympanic branch of the glossopharyngeal nerve (CN IX)?

Answer 5

tonsilits

peritonsilar abscess/quinsy

post-tonsillecotmy

carcinoma at the base (posterior 1/3rd) of the tongue or tonsil

neuralgia of the glossopharyngeal nerve (CN IX)

Question 6

What pathologies can cause otalagia via the auricular branch of the vagus nerve (CN X)?

Answer 6

foreign body in the piriform fossa - e.g fishbones

carcinoma of the piriform fossa

carcinoma of the larynx

post-circoid carcinoma

sepsis - from piriform abscess

Question 7

What pathologies can cause otalgia via the great auricualr nerve (C2/C3)?

Answer 7

cercvical neuritis

Herpes Zoster

Question 8

What pathologies can cause otalgia via the lesser occipital nerve (C2/C3)?

Answer 8

cervical spondylosis

cervical neuritis

Herpes Zoster