[Causes of otalgia from outside the ear]

Two patients, a man aged 50 and a woman aged 61 years, complained about otalgia without a hearing disorder. Both patients exhibited slight mucosal redness of the upper airway at examination of the ear, nose, and throat, but no other abnormalities. Subsequent CT investigations of the ear and paranasal sinuses revealed no pathology in either patient. The first patient's condition deteriorated; he was eventually found to have a bronchial carcinoma that might have involved the vagal nerve. The second patient, who had a diaphragmatic hernia, improved dramatically once her daily dose of omeprazole had been augmented. It seems that both patients suffered from otalgia referred by the vagal and/or glossopharyngeal nerve.