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Clinical Guide - Referred Otalgia

The following is some brief guidance on the management of referred otalgia. It is written with the intention of helping the Ear Practitioner to diagnose diseases that cause referred ear pain and to know when to refer for specialist treatment. It does not replace a good knowledge of the underlying anatomy, physiology or pathology and these must be studied as well.


You should use this guide only after a careful history has been taken and an examination performed.


Remember these key features:


  1. Referred otalgia is diagnosed when the patient complains of ear pain but the ear exam is normal

  2. If the patient has hoarseness, pain on swallowing is a long-term smoker or an alcoholic you must consider cancer as a possibility and refer

  3. You must examine the patient’s mouth, teeth, and tongue for infections and cancers

  4. You must examine the neck for lumps

  5. You should palpate the temporomandibular joint and the muscles attached to it

  6. You must keep a careful note of the history and examination

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