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Abstract

ABSTRACT: BACKGROUND: Otalgia is defined as ear pain. It is one of the complaints which may occur at any age. The etiology of the pain may be in the ear, structures around the ear or other head and neck structures This is caused by the complex nervous connections in the head and neck areas, the ear, the pharynx and the nose. objective: since understanding the etiologies of referred otalgia can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred otalgia in patients visiting the ENT Clinic in mosul , Iraq OBJECTIVE: Since understanding the etiologies of referred otalgia can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred otalgia in patients visiting the ENT Clinic in Mosul , Iraq. We have reviewed the complex neuroanatomic basis of nonotogenic ear pain PATIENT AND METHODS: A prospective study of 211 patients with ear pain. During a 12 month period from 2010 to2011,two hundred and eleven patients with otalgia were studied, they were attendant of the outpatient clinic of ENT department in Al-Jumhury Teaching Hospital. Patient age ,gender ,occupation, residence were recorded in a representative questionnaire form. All patients had a normal otologic examination and diagnosed with causes for referred otalgia were categorized according to distribution of cranial nerve, gender and age. RESULTS: The majority of causes of otalgia (64%)were due to referred pain, while only(35.5)of causes were due to ear leasions. significantly referred pain affected patient above the age of 15yr more than those below the age of 15yr .The most common cause for referred otalgia in Females was Temporomandibular joint (TMJ) dysfunction (29.2%);while cervical spine lesion was commonest in male. The trigeminal nerve was the major cranial nerve causing referred pain in both gender (53.7) CONCLUSION: Since the early 1900s, referred otalgia has been a well-documented phenomenon in the ear, nose, and throat (ENT) and neurosurgical literature. However, Essentially any pathology residing within the sensory net of cranial nerves V, VII, IX, and X and upper cervical nerves C2 and C3 can potentially cause referred otalgia. A thorough understanding of the various sensorineural pathways that dually innervate the ear and other sites and ongoing dialogue with our clinical colleagues, will ensure that patients with referred otalgia will receive the best care in the head and neck.

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