Frequency of Involvement of Different Head and Neck Sites in Referred Otalgia

Aim: To find out the most frequent head and neck sites of origin of referred otalgia.

Study Design: Descriptive cross-sectional.

Place and Duration of Study: Study was conducted at the ENT department of Bahawal Victoria hospital Bahawalpur during January 2019 to December 2019.

Methodology: About 500 patients with ear ache were examined and after exclusion 150 were finally analyzed. Detailed history of the patient and clinical examination were done along with radio imaging and endoscopic studies wherever needed. Diagnosis of referred otalgia was made after having normal ear examination along with pathology lying at different head and neck region which share common sensory innervation. For analysis SPSS version-20 was used.

Results: The mean age of the study participants was 28.23 ±13 years. The majority of participants were having otalgia of tonsillar origin followed by dental origin and pharyngitis with 31.3%, 23.3% and 16% respectively. Very few of them having otalgia originating from hypopharyngeal carcinoma and laryngeal carcinoma i.e. 3.3% and 2% respectively. While only 4.7% of otalgia were of unknown origin. Female participants were having higher frequency of otalgia which is originated from diseases of temporomandibular joint, hypopharyngeal carcinoma and otalgia of unknown origin in comparison to male participants but differences were insignificant. Otalgia originated from tonsillar and dental causes and due to pharyngitis were most common among the younger age group but having non-significant p-value.

Conclusion: It has been concluded that the patients presenting with ear pain, have sometimes no underlying ear pathology. If the ear examination is normal then it is important to examine all other sites of head and neck which share sensory innervation with the ear including teeth, tonsils, pharynx, larynx, nose and paranasal sinuses to find out the exact cause of referred otalgia.