eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > External Ear Diseases

Otalgia: Follow-up

Author: John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
Coauthor(s): Jared Brunk, PA-C, Physician Assistant Certified, Office of John Li, MD
Contributor Information and Disclosures

Updated: Aug 26, 2008

Follow-up

Patient Education

For excellent patient education resources, visit eMedicine's Ear, Nose, and Throat Center. Also, see eMedicine's patient education articles Earache and Tinnitus.

Miscellaneous

Medicolegal Pitfalls

  • One of the most dangerous pitfalls in the workup of referred otalgia is overlooking a carcinoma of the head and neck. Knowledge of pain referral patterns and neural pathways is important.
  • The authors would caution the practitioner to maintain persistence and vigilance in discovering the source of the problem. Prudent use of the fiberoptic nasolaryngoscope is well advised.
  • Do not be overly hesitant in using neuroimaging modalities to make a diagnosis.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Thomas Ulrich, PA, to the development and writing of this article.



More on Otalgia

Overview: Otalgia
Differential Diagnoses & Workup: Otalgia
Treatment & Medication: Otalgia
Follow-up: Otalgia
Multimedia: Otalgia
References

References

  1. Adour KK. Acute temporomandibular joint pain-dysfunction syndrome: neuro-otologic and electromyographic study. Am J Otolaryngol. May 1981;2(2):114-22. [Medline].

  2. Al-Sheikhli AR. Pain in the ear--with special reference to referred pain. J Laryngol Otol. Dec 1980;94(12):1433-40. [Medline].

  3. Frankel VH. Whiplash injuries to the neck. In: Hirsch C, Zotterman Y, eds. Cervical Pain. New York, NY: Pergamon Press; 1971.

  4. Gibson WS Jr, Cochran W. Otalgia in infants and children--a manifestation of gastroesophageal reflux. Int J Pediatr Otorhinolaryngol. 1994;Jan;28(2-3):213-8.

  5. Goethals PL. Referred otalgia. JFMA. Jun 1972;59(6):26-30. [Medline].

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  7. Kuttila S, Kuttila M, Le Bell Y. Characteristics of subjects with secondary otalgia. J Orofac Pain. Summer 2004;18(3):226-34.

  8. Malik MK, Sharma JK. Referred otalgia of dental origin. J Indian Dent Assoc. Oct 1975;47(10):413-6. [Medline].

  9. Olsen KD. The many causes of otalgia. Infection, trauma, cancer. Postgrad Med. Nov 1 1986;80(6):50-2, 55-6, 61-3. [Medline].

  10. Sataloff RT, Price DB. Distention of the stylomandibular ligament as a cause of styloid pain syndrome. Ear Nose Throat J. Sep 1984;63(9):412-5. [Medline].

  11. Scarbrough TJ, Day TA, Williams TE. Referred otalgia in head and neck cancer: a unifying schema. Am J Clin Oncol. 2003;Oct;26(5):e157-62.

  12. Shah RK, Blevins NH. Otalgia. Otolaryngol Clin North Am. Dec 2003;36(6):1137-51. [Medline].

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  14. Thaller SR, De Silva A. Otalgia with a normal ear. Am Fam Physician. Oct 1987;36(4):129-36. [Medline].

  15. Travell JG, Simons DG. Myofascial pain and dysfunction. In: The Trigger Point Manual. Baltimore, Md: Lippincott Williams & Wilkins; 1983.

  16. Wazen JJ. Referred otalgia. Otolaryngol Clin North Am. Dec 1989;22(6):1205-15. [Medline].

  17. Williamson EH. The interrelationship of internal derangements of the temporomandibular joint, headache, vertigo, and tinnitus: a survey of 25 patients. Facial Orthop Temporomandibular Arthrol. Jan 1986;3(1):13-7. [Medline].

  18. Yules RB. Differential diagnosis of referred otalgia. Eye Ear Nose Throat Mon. May 1967;46(5):587-8. [Medline].

Further Reading

Keywords

otalgia, chronic otalgia, chronic, otalgia definition, ear pain, earache, primary otalgia, referred otalgia, external otitis, otitis media, mastoiditis, auricular infections, tympanic membrane perforation, ear infections

Contributor Information and Disclosures

Author

John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society
Disclosure: Nothing to disclose.

Coauthor(s)

Jared Brunk, PA-C, Physician Assistant Certified, Office of John Li, MD
Disclosure: Nothing to disclose.

Medical Editor

Michael E Hoffer, MD, Director, Spatial Orientation Center, Department of Otolaryngology, Naval Medical Center of San Diego
Michael E Hoffer, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: American biloogical group Royalty Other

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Peter S Roland, MD, Professor, Department of Neurological Surgery, Professor and Chairman, Department of Otolaryngology-Head and Neck Surgery, Director of Clinical Center for Auditory, Vestibular and Facial Nerve Disorders, Chief of Pediatric Otology, University of Texas Southwestern Medical Center; Adjunct Professor of Communicative Disorders, School of Human Development.
Peter S Roland, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Auditory Society, American Laryngological Rhinological and Otological Society, American Neurotology Society, American Otological Society, North American Skull Base Society, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Alcon labs Honoraria Speaking and teaching; GSK Honoraria Speaking and teaching; Advanced Bionics Honoraria Board membership; Cochlear corp Honoraria Board membership; Med El corp travel grants Speaking and teaching; Insight vision Consulting fee Consulting

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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