Referred pain in ear is due to all EXCEPT:
Correct Answer: Furunculosis
Description: The neuroanatomic basis of referred otalgia rests within one of five general neural pathways. The general ear region is sensorily innervated four cranial nerves and two spinal segments. Hence, pathology in other "non-ear" pas of the body innervated by these neural pathways may "refer" pain to the ear. These general pathways are: Via Trigeminal nerve . Rarely, trigeminal neuralgia can cause otalgia. Oral cavity carcinoma can also cause referred ear pain this pathway. Via Facial nerve . This can come from the teeth (most commonly the upper molars, when it will be worse when drinking cold fluids), the temporomandibular joint (due to its close relation to the ear canal), or the parotid gland. Via Glossopharyngeal nerve . This comes from the oropharynx, and can be due to pharyngitis or tonsillitis, or to carcinoma of the oropharynx (base of tongue, soft palate, pharyngeal wall, tonsils). Via Vagus nerve . This can arise from the laryngopharynx in carcinoma of this area, or from the esophagus in GERD. Via the second and third spinal segments, C2 and C3. In an adult with chronic ear pain, yet a normal ear on exam, the diagnosis is carcinoma of the head and neck region until proven otherwise. Yet some patients will have a "psychogenic otalgia," and no cause as to the pain in ears can be found (suggesting a psychosomatic origin). The patient in such cases should be kept under observation with periodic re-evaluation.
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ENT
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