REVIEW ARTICLE The Radiology of Referred Otalgia

SUMMARY: Pain referred to the ear is a well-documented phenomenon, which can be due to a multitude of disease processes. With the recent and rapid progression of CT and MR imaging technology, radiologists have played an increasing role in solving this potentially difficult diagnostic dilemma. Essentially any pathology residing within the sensory net of cranial nerves V, VII, IX, and X and the upper cervical nerves C2 and C3 can potentially cause referred otalgia. This article will attempt to outline the various sensorineural pathways that dually innervate the ear and other sites within the head and neck, as well as discuss various disease processes that are known to result in referred otalgia. Ear pain (otalgia) can be divided into 2 main categories:primary and secondary.1 Primary ear pain is an entity whereby the origin of the pain arises from the ear itself. Com-mon disease processes resulting in primary otalgia include otomastoiditis, cholesteatoma, and foreign bodies lodged within the ear canal. In close to 50 % of cases, however, the source of the pain does not reside within the ear but, rather, originates from sources distant from the ear—so called “re