otalgia

Question 1

what can cause otalgia in the pinna and ear canal?

Answer 1

Folliculitis
Cellulitis
Perichondritis
Sebaceous cyst
Candidiasis
Herpes zoster, Herpes simplex
SCC of ear canal
local reaction to therapies
trauma to the ear

Question 2

what can cause otalgia in the tympanic membrane?

Answer 2

Myringitis – Ramsay Hunt Syndrome, Myringitis bullosa
Inflammation secondary to otitis media

Question 3

what can cause otalgia in the middle ear?

Answer 3

Cholesteatoma
Otitis media – viral or bacterial
Middle ear effusion – sterile or infective

Question 4

what is ramsay hunt syndrome?

Answer 4

shingles infection spreads to facial nerve which can cause unilateral facial paralysis and hearing loss

Question 5

what is otitis media?

Answer 5

infection of the middle ear that causes inflammation and a build-up of fluid behind the eardrum
usually viral but can be bacterial

Question 6

what cranial nerves cause referred pain to the ears?

Answer 6

CN V (trigeminal)
CN VII (facial)
CN IX (glossopharyngeal)
CN X (vagus)

Question 7

what joint can cause referred pain to the ear?

Answer 7

temporo-mandibular joint

Question 8

what are some causes of referred ear pain form CN V3?

Answer 8

• Lower mandibular pathology e.g. dental abscess
• Temporo-mandibular joint lesions - e.g. Costen’s syndrome
• Infection/inflammation anterior 2/3 of tongue - piercings
• Stress – tooth grinding
• Salivary gland disease
• Infection – viral (mumps), bacterial, neoplasms

Question 9

what are some causes of referred ear pain form CN VII?

Answer 9

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

Question 10

what are some causes of referred ear pain from CN IX?

Answer 10

tonsillitis or quinsy
post-tonsillectomy
carcinoma at the base (posterior 1/3) of the tongue or tonsil
neuralgia of the glossopharyngeal nerve

Question 11

what are the 6 Ts or referred causes of otalgia?

Answer 11

teeth
tongue
tonsils
throat
TMJ
trigeminal myalgia

Question 12

what are some causes of referred ear pain form CN X?

Answer 12

Foreign body in piriform fossa - fishbones
carcinoma of the piriform fossa
carcinoma of the larynx
post-cricoid carcinoma
Sepsis – piriform abscess

Question 13

what is hyperacusis?

Answer 13

increased sensitivity to noise so everything seems loud