Referred Otalgia

Auriculo-temporal branch of the trigeminal nerve

  • Lower mandibular pathology
    • Dental abscess
    • Dental caries
    • Impacted molar teeth
  • Temporomandibular joint lesions - e.g. Costen's syndrome
  • Infection/inflammation on the anterior 2/3 tongue - piercings
  • Stress - tooth grinding
  • Salivary gland disease
    • Infection - viral (mumps), bacterial
    • Stones
    • Neoplasm

Sensory branch of the facial nerve (CN VII)

  • Geniculate herpes/Ramsay Hunt syndrome linked to facial palsy
  • Sphenoid or ethmoidal sinus pathology - infection, neoplasm
  • Nasal pathology - including foreign bodies

Tympanic branch of the glossopharyngeal nerve (CN IX)

  • Tonsillitis or quinsy
  • Post-tonsillectomy
  • Carcinoma at the base (posterior 1/3) of the tongue or tonsil
  • Neuralgia of the glossopharygeal nerve

Cranial nerves (CN X)

  • Foreign body in piriform fossa - fishbones
  • Carcinoma of the piriform fossa
  • Carcinoma of the larynx
  • Post-cricoid carcinoma
  • Sepsis - piriform abscess

Cervical spine

Greater auricular nerve (C2/3)

  • Cervical neuritis
  • Herpes Zoster

Lesser occipital nerve (C3)

  • Cervical spondylosis
  • Cervical neuritis
  • Herpes Zoster

Summary

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