Otolaryngology resident at the University of Calgary in Alberta.
Medical student in the Cumming School of Medicine at the University of Calgary.
Can Fam Physician. 2023 Nov;69(11):757-761. doi: 10.46747/cfp.6911757.
To provide family physicians and general otolaryngologists with a practical, evidence-based, and comprehensive approach to the management of patients presenting with suspected referred otalgia.
The approach described is a review based on the authors' clinical practices along with research and clinical review articles published between 2000 and 2020. MEDLINE and PubMed were searched using the terms , , and . Current guidelines for the management of referred otalgia were also reviewed.
Otalgia is defined as pain localized to the ear. It is one of the most common head and neck presentations in primary care, otolaryngology, and emergency medicine. Secondary otalgia arises from nonotologic pathology and represents nearly 50% of otalgia cases. Otalgia in the absence of other otologic symptoms is highly indicative of a secondary cause. A thorough assessment of patients presenting with referred otalgia requires an understanding of the possible causes of this condition, including dental and oral mucosal pathologies, temporomandibular joint disorders, cervical spine pathology, sinusitis, upper airway infection, and reflux, as well as head and neck malignancy. This paper aims to highlight the most common causes of referred otalgia, their presentations, and initial options for assessment and management.
The prevalence of referred otalgia makes this an important condition for family physicians to be able to assess, manage, and triage based on patient presentation and examination. Understanding the common causes of referred otalgia will help reduce wait times for specialist assessment and allow ease and speed of access to management options for patients in community clinics.
为家庭医生和普通耳鼻喉科医生提供一种实用、基于证据且全面的方法来处理表现为疑似牵涉性耳痛的患者。
所描述的方法是基于作者的临床实践以及 2000 年至 2020 年期间发表的研究和临床综述文章的综述。使用术语 、 、 检索 MEDLINE 和 PubMed。还审查了牵涉性耳痛管理的当前指南。
耳痛定义为局限于耳部的疼痛。它是初级保健、耳鼻喉科和急诊医学中最常见的头颈部表现之一。继发耳痛源于非耳科病理学，占耳痛病例的近 50%。在没有其他耳科症状的情况下出现耳痛，高度提示为继发原因。对表现为牵涉性耳痛的患者进行彻底评估需要了解这种情况的可能原因，包括牙齿和口腔黏膜病理学、颞下颌关节紊乱、颈椎病理学、鼻窦炎、上呼吸道感染和反流，以及头颈部恶性肿瘤。本文旨在强调牵涉性耳痛的最常见原因、其表现以及评估和管理的初始选择。
牵涉性耳痛的患病率使得家庭医生能够根据患者的表现和检查进行评估、管理和分诊。了解牵涉性耳痛的常见原因将有助于减少专家评估的等待时间，并为社区诊所的患者提供管理选择的便利性和速度。
