Pediatric emergency medicine trisk 1133 1133
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Patients may complain of ear pain when suffering from nonotogenic conditions.
The sensory innervation of the auricle, external auditory canal, middle and inner
ear involve cranial nerves V, VII, IX, and X. These same cranial nerves,
particularly VII, IX, and X, also provide sensory innervation of the mouth, throat,
and sinuses. Referred pain from pharyngitis, sinusitis, stomatitis, dental
infections, and in rare cases, tumors of the head and neck may be experienced as
ear pain. The postauricular area is supplied by C2 and C3, and neck injuries, disc
problems, arthritis may cause referred pain to that region. When no otic cause is
found in children presenting with ear pain, clinicians should carefully evaluate the
surrounding structures to identify other causes of the discomfort.
The Children’s Hospital of Philadelphia Clinical Pathway
Clinical Pathway for Evaluation/Treatment of Acute Otitis Media in
Children 2 Months to 12 Years Old
URL: />Author: M. Joffe, MD
Posted: November 2008, last revised January 2020
Suggested Readings and Key References
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postpneumococcal conjugate vaccine era. Pediatrics 2017;140(3):e20170181.
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diagnosis and management of acute otitis media. Pediatrics 2013;131(3):e964–
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