Nonotogenic otalgia: diagnosis and treatment.

Nonotogenic otalgia may be due to referred or reflex pain, neuralgia, or to a psychogenic problem. Referred pain is due to irritative lesions involving the fifth, ninth, or tenth cranial nerves and spinal nerves C2 and C3. If pathologic problems in the area supplied by these nerves have been ruled out, the neuralgia should be considered in the differential diagnosis. Psychogenic factors must be identified and treated before any type of surgical therapy is recommended.