Otalgia By

Lt Col Dr Saeed Ullah MBBS, FCPSClassified ENT, Head and Neck Surgeon

Parts of ear

Nerve supply of ear

Nerve supply EACAuriculotemporal nerve (V3)Facial nerve Auricular branch of Vagus nerve

Nerve supply of TMAuriculo temporal nerveAuricular branch of VagusJacobson’s nerve

Nerve supply of middle earTympanic plexusJacobson’s nerve Chorda tympani

Types of otalgiaPrimary otalgiaReferred otalgia

Referred otalgiaPain originated outside the ear, but felt in the

ear

Causes Primary otalgia

Pinna External auditory canalMiddle earMastoid air cell system

Pinna Laceration and biteHematomaPerichondritisOtitis externaInfected pre-auricular sinusFrost bite and sunburnNeoplasm

External auditory canalImpacted waxForign bodiesOtitis externaKeratosis obturansExostosisHerpes zoster oticusNeoplasm

TM & Middle ear Bullous myringitisAcute otitis mediaSecretory otitis mediaBarotraumaTraumatic perforation of TMHemotympanumNeoplasm

Mastoid MastoiditisMastoid abscessGranulomaNeoplasm

Inner ear Trauma & fractures of temporal boneMeniere,s disease Vestibular schwanoma

Nerves of referred pain Trigeminal nerveGlossopharyngeal nerveVagus nerveFacial nerve2nd and 3rd cervical nerves

Via 2nd and 3rd cervical nervesHerpes zosterArthritis of TM joint Spondylosis of TM joint

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