Otalgia

Otalgia is frequently seen in general practice. It can be broadly divided into primary otalgia, which includes the diseases occurring largely within the ear, or secondary otalgia, which is pain referred to the ear by travelling along cranial nerves that supply both the ear and referred region. The causes of secondary otalgia may require more extensive examination and investigation to define the aetiology.

The aims of this article are to outline the most common causes of otalgia seen in general practice, and provide a pragmatic approach to initial assessment and deciding when to refer for specialist review.

The most common cause of primary otalgia is infection. Other causes require a greater index of suspicion. Specialist referral could be made if there are complications of primary otalgia or if a secondary cause needs to be excluded in a patient with a normal otology examination.