Sussman Sarah, Zimmerman Zachary, Chishom Taylor, Reid Lauren, Seyyedi Mohammad
Department of Otolaryngology, Medical College of Georgia Augusta University, Augusta, GA, USA.
Department of Otolaryngology, Northwestern University, Chicago, IL, USA.
J Audiol Otol. 2022 Apr;26(2):90-96. doi: 10.7874/jao.2021.00465. Epub 2022 Feb 24.
Otalgia can be primary/otogenic or secondary as a referred pain from another site, which can be difficult to establish owing to various causes and the complex innervation of the ear. In our center, we observed a large group of patients with unexplained otalgia that had a higher prevalence of migraine. We hypothesized that migraine may cause secondary otalgia. This study then aimed to determine the prevalence of migraine-associated otalgia and evaluate the efficacy of migraine treatment.
This 2-year retrospective study was conducted at a busy otology clinic. Patients were identified using diagnostic codes corresponding to otalgia. The prevalence of migraine-associated otalgia was determined, and the efficacy of migraine treatment was evaluated in these patients. The interventions included prophylactic and abortive migraine treatments. Statistical analysis was conducted to compare between the pre- and post-treatment symptoms.
A total of 208 patients with otalgia were identified. Sixty-four out of ninety patients with unexplained otalgia met the criteria for migraine; of them, 30 patients had an adequate follow-up and were thus included in the evaluation of treatment efficacy. Otalgia improved in 87% of the patients who received migraine treatment. After treatment, the mean pain score and headache frequency significantly decreased from 7 to 2 and from 27 to 9 days per month, respectively (p<0.001).
Migraine should be considered as a source of secondary otalgia, and patients should receive treatment as they often respond to migraine treatment.
耳痛可为原发性/耳源性，也可为继发于其他部位的牵涉痛，由于多种原因及耳部复杂的神经支配，耳痛的病因难以确定。在我们中心，我们观察到一大群不明原因耳痛的患者中偏头痛患病率较高。我们推测偏头痛可能导致继发性耳痛。本研究旨在确定偏头痛相关性耳痛的患病率，并评估偏头痛治疗的疗效。
这项为期2年的回顾性研究在一家繁忙的耳科诊所进行。使用与耳痛对应的诊断编码来识别患者。确定偏头痛相关性耳痛的患病率，并评估这些患者偏头痛治疗的疗效。干预措施包括预防性和发作期偏头痛治疗。进行统计分析以比较治疗前后的症状。
共识别出208例耳痛患者。90例不明原因耳痛患者中有64例符合偏头痛标准；其中30例患者有充分的随访，因此被纳入治疗疗效评估。接受偏头痛治疗的患者中87%的耳痛得到改善。治疗后，平均疼痛评分和头痛频率分别从7分显著降至2分，每月头痛天数从27天降至9天（p<0.001）。
偏头痛应被视为继发性耳痛的一个原因，且患者通常对偏头痛治疗有反应，应接受治疗。
