PT  - JOURNAL ARTICLE
AU  - Norris, C.D.
AU  - Koontz, N.A.
TI  - Secondary Otalgia: Referred Pain Pathways and Pathologies
AID  - 10.3174/ajnr.A6808
DP  - 2020 Dec 01
TA  - American Journal of Neuroradiology
PG  - 2188--2198
VI  - 41
IP  - 12
4099  - http://www.ajnr.org/content/41/12/2188.short
4100  - http://www.ajnr.org/content/41/12/2188.full
SO  - Am. J. Neuroradiol.2020 Dec 01; 41
AB  - SUMMARY: Otalgia is very common, and when the cause of ear pain is not identified on otoscopy and physical examination, cross-sectional imaging is routinely used to evaluate for potential sources of referred ear pain (secondary otalgia). Innervation of the ear structures is complex, involving multiple upper cervical, lower cranial, and peripheral nerves, which transit and innervate a large anatomic territory involving the brain, spine, skull base, aerodigestive tract, salivary glands, paranasal sinuses, face, orbits, deep spaces of the neck, skin, and viscera. Interpreting radiologists must be familiar with these neural pathways and potential sources of secondary otalgia. The purposes of this review are to detail the currently proposed mechanisms of referred ear pain, review the salient neuroanatomy of the complex pathways responsible for secondary otalgia, highlight important benign and malignant etiologies of referred ear pain, and provide a structured search pattern for approaching these challenging cases on cross-sectional imaging.CNcranial nerveTMJtemporomandibular joint