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Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses
Munira Ally1, Ahmad Moinie1, Joan Lomas2
1ENT Department, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB, Hertfordshire, UK.
Objectives Of Review:
To review the literature for the evidence base for the aetiology and management of referred otalgia, looking particularly at non-malignant, neuralgic, structural and functional issues.
Type Of Review:
Systematic review.
Search Strategy:
A systematic literature search was undertaken from the databases of EMBASE, CINAHL, MEDLINE®, BNI, and Cochrane Library according to predefined inclusion and exclusion criteria.
Evaluation Method:
All relevant titles, abstracts and full text articles were reviewed by three authors who resolved any differences by discussion and consultation with senior author.
Results:
44 articles were included in our review. The overall quality of evidence was low, with the vast majority of the studies being case-series with three cohort and four randomised-controlled trials included. The prime causes and management strategies were focussed on temporomandibular joint dysfunction (TMJD), Eagle syndrome and neuralgia. Our meta-analyses found no difference on the management strategies for the interventions found.
Conclusions:
Referred otalgia is common and treatment should be aimed at the underlying pathology. Potential aetiologies are vast given the extensive sensory innervation of the ear. An understanding of this and a structured approach to patient assessment is important for optimal patient management.
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