Referred otalgia

Question 1

where can pain come from?

Answer 1

teeth
temporomandibular joint from the auriculotemporal nerve (a branch of the manibular Vth cranial nerve)
cervical spinal problems C1 to C3
tonsil and tongue base problems form the glossopharyngeal (Jacobson’s) nerve
larynx and pharynx from the vagus (Arnold’s) nerve
Ramsay hunt syndrome - causing vesicles along the distribution of the VIIth cranial nerve

Question 2

what is the innervation of the pinna?

Answer 2

innervation of the pinna is from the auriculotemporal branch of the trigeminal and 1st 2 cervical nerves

Question 3

what 3 types of pain which can refer to the ear due to their close anatomical innervation?

Answer 3

dental pain
temporomandibular joint dysfunction
upper cervical arthritis

Question 4

how does Ramsay Hunt syndrome cause referred ear pain?

Answer 4

Varicella reactivation along the sensory division of the facial nerve (Ramsay Hunt syndrome) can cause otalgia in the ear canal because of the facial nerve innervation of the ear

Question 5

how does pain from the larynx and pharynx refer to the ear?

Answer 5

because of referred pain along the vagus nerve

middle ear is innervated by the glossopharyngeal nerve and so infections of the pharynx are associated with otalgia