12 minute consultation: an evidence-based management of referred otalgia

Background: Otalgia is a common presenting symptom to the ENT clinic. The aetiology of otalgia can be divided into otological and referred depending on its underlying pathology. This article aims to provide a systematic and evidence-based method of managing a patient with referred otalgia. Methods: The data in this article are based on a literature review performed on MEDLINE and EMBASE in January 2010. The keywords used included otalgia in combination with diagnosis, management, investigations and treatment. Articles in the English language were selected and reviewed. Suitable references from these articles were also reviewed. Results: The majority of published literature on the management of diseases causing referred otalgia is level III/IV evidence. Conclusions: An understanding of the different causes of referred otalgia is essential as it can be multifactorial in origin. The main concern in a patient with referred otalgia is overlooking a malignant lesion in the upper aerodigestive tract or base of skull/infratemporal fossae. A thorough history followed by a systematic examination usually helps to arrive at a diagnosis. Treatment should be directed towards the underlying pathology.