earache, pain in ear, otalgia causes Pain in the ears (Otalgia) may occur either due to causes in the ear or causes somewhere else having same sensory nerve supply as the ear (referred otalgia). The causes in the ear may be either in external ear or middle ear. Inner ear has no pain fibres, so diseases of the inner ear are mostly painless.

The common causes in the external ear are:

1- Acute diffuse otitis externa

2- Boil

3- Otomycosis

4- Bullous myringitis

5- Herpes zoster oticus

6- Perichondritis

7- Trauma or foreign body

8- Impacted wax

9- Malignant otitis externa

10- Neoplasia



The common causes in the middle ear are:

1- Acute suppurative otitis media

2- Acute on chronic otitis media

3- CSOM with complications

4- Mastoid abscess

5- Trauma

6- Otitic barotrauma

7- Neoplasms




A good number of patients complaining of earache have disease somewhere else. This is due to common sensory nerve supply with the ear. The ear is supplied by the branches of trigeminal, facial, glossopharyngeal, vagus, greater auricular and lesser occipital nerves. Any painful pathology in the distribution of these nerves may cause referred pain in the ear.


Some of the common causes of referred otalgia



1- After tonsillectomy operation

2- After adenoidectomy operation

3- Dental diseases

4- Carcinoma of pyriform fossa, base of tongue and tonsil

5- Nasal and PNS diseases

6- Acute tonsillitis

7- Peritonsillar abscess

8- Ulcers in mouth and pharynx

9- Cervical spondylosis or arthritis

10- Nasopharyngeal diseases

11 - Temporo-mandibular joint dysfunction

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