Etiology of referred otalgia

Otalgia is defined as ear pain. It is one of the complaints which may occur at any age. The etiology of the pain may be in the ear, structures around the ear or other head and neck structures. This is caused by the complex nervous connections in the head and neck areas, the ear, the pharynx and the nose. Since understanding the etiologies of referred otalgia can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred otalgia in patients visiting the ENT Clinic in Mosul, Iraq. Since understanding the etiologies of referred otalgia can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred otalgia in patients visiting the ENT Clinic in Mosul, Iraq. We have reviewed the complex neuroanatomic basis of nonotogenic ear pain. A prospective study of 211 patients with ear pain. During a 12 month period from 2010 to 2011, two hundred and eleven patients with otalgia were studied, they were attendant of the outpatient clinic of ENT department in Al-Jumhury Teaching Hospital. Patient age, gender, occupation, residence were recorded in a representative questionnaire form. All patients had a normal otologic examination and diagnosed with causes for referred otalgia were categorized according to distribution of cranial nerve, gender and age. The majority of causes of otalgia [64%] were due to referred pain, while only [35.5] of causes were due to ear leasions. Significantly referred pain affected patient above the age of 15yr more than those below the age of 15yr .The most common cause for referred otalgia in Females was Temporomandibular joint [TMJ] dysfunction [29.2%];while cervical spine lesion was commonest in male. The trigeminal nerve was the major cranial nerve causing referred pain in both gender [53.7]. Since the early 1900s, referred otalgia has been a well-documented phenomenon in the ear, nose, and throat [ENT] and neurosurgical literature. However, Essentially any pathology residing within the sensory net of cranial nerves five, seven, nine, and ten and upper cervical nerves C2 and C3 can potentially cause referred otalgia. A thorough understanding of the various sensorineural pathways that dually innervate the ear and other sites and ongoing dialogue with our clinical colleagues, will ensure that patients with referred otalgia will receive the best care in the head and neck.

Correção da orelha em banco pela técnica de Converse e Wood-Smith / Correction of the ear in the bank by the technique of Converse and Wood-Smith

A orelha em abano é uma deformidade congênita comum na prática do cirurgião plástico, ela pode acarretar problemas psicológicos e alterações no relacionamento do paciente com seus semelhantes. Esta monografia descreve os aspectos embriológicos, anatômicos assim como a evolução histórica das técnicas utilizadas para o tratamento da deformidade , fazendo ênfase na técnica descrita por Converse e Wood-Smith. Considerada pelo autor, uma técnica eficaz, versátil e de fácil reprodução para o tratamento da deformidade.

Great auricular nerve involvement in leprosy: scope for misdiagnosis.

Three patients with neuritis of the great auricular nerve (GAN) have been reported. Two patients seen by physicians and an otolaryngologist had prominent and tender cord along the neck with facial edema and history of fainting attack in one, and erythema and hyperaesthesia of the ear in the other simulating vascular occlusion, which were confirmed to be leprosy in Type 1 reaction by the dermatologist. In the third, cold abscess in the nerve that had persisted after anti-leprosy treatment was mistaken as tuberculous cervical lymphadenitis by a surgeon since aspiration had revealed acid-fast bacilli. The probable reasons for misdiagnosis include rarity of involvement of the GAN and its proximity to main blood vessels, and the need for careful interpretation of laboratory results.

Greater auricular nerve conduction in leprosy.

Greater auricular sensory nerve conduction was performed in 18 'control' subjects (36 nerves) and normal values for various parameters were determined. In 10 (16 nerves) of the 12 (24 nerves) leprosy patients in whom similar study was performed, abnormal conduction was found. All the eight thickened nerves and 8 of 16 clinically normal nerves in leprosy patients were found to have electrophysiological abnormalities. The usefulness of this procedure in the diagnosis of leprosy is emphasised.