Referred otalgia.

Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source. The rich sensory innervation of the ear derives from four cranial nerves and two cervical nerves which also supply other areas in the head, neck, thorax, and abdomen. Pain referred to the ear may originate in areas far removed from the ear itself. Neoplastic, infectious, inflammatory, musculoskeletal, and vascular disorders must all be considered when evaluating the patient with otalgia and a normal ear examination. Otalgia is frequently the presenting complaint in patients with carcinoma of the oropharynx or hypopharynx. This article reviews the anatomic basis for referred otalgia and overviews the common etiologies responsible for this symptom.