Otalgia

Pain localized to the external, middle, or inner ear, arising from primary ear disease or referred pain from adjacent head and neck structures sharing sensory nerve pathways.

Causes

• External ear causes

  • Otitis externa (“swimmer’s ear”)

  • Fungal otitis externa (otomycosis)

  • Ear canal trauma

  • Foreign body in the ear canal

  • Cerumen impaction

  • Skin infections or dermatitis of the external auditory canal

  • Herpes zoster oticus (Ramsay Hunt syndrome)

• Middle ear causes

  • Acute otitis media

  • Chronic otitis media

  • Eustachian tube dysfunction

  • Middle ear effusion (otitis media with effusion)

  • Tympanic membrane perforation

  • Barotrauma from pressure changes (air travel, diving)

  • Mastoiditis

• Inner ear inflammation

  • Labyrinthitis

  • Other disorders affecting cochlear or vestibular structures

• Referred pain from adjacent structures

  • Temporomandibular joint (TMJ) disorders

  • Dental abscess

  • Dental caries

  • Tongue inflammation or lesions

  • Tonsillitis

  • Pharyngitis

  • Laryngitis

  • Head and neck malignancies

• Neurological and nerve-related causes

  • Trigeminal neuralgia

  • Glossopharyngeal neuralgia

  • Cervical spine disorders causing referred otalgia

  • Neural irritation involving shared sensory pathways

• Trauma to the ear or surrounding structures