Left Ear Pain Icd 10
ICD-10 code H92.02 for Otalgia, left ear is a medical classification medical classification A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. https://en.wikipedia.org › wiki › Medical_classification
- 0.1 Medical classification – Wikipedia
- 0.2 Mastoid part of the temporal bone – Wikipedia
- 0.3 What is the ICD-10 code for ear pain both ears?
- 1 What is the ICD-10 code for left otitis externa?
- 2 What is the ICD-10 code for chronic ear infection?
- 3 What is the ICD-10 code for left ear cyst?
- 4 What is an example of otalgia?
Medical classification – Wikipedia
as listed by WHO under the range – Diseases of the ear and mastoid process mastoid process The mastoid part of the temporal bone is the posterior (back) part of the temporal bone, one of the bones of the skull. Its rough surface gives attachment to various muscles (via tendons) and it has openings for blood vessels.
Mastoid part of the temporal bone – Wikipedia
Introduction – Otalgia (ear pain) divides into two broad categories: primary and secondary otalgia. Primary otalgia is ear pain that arises directly from pathology within the inner, middle, or external ear. Secondary or referred otalgia is ear pain that occurs from pathology located outside the ear.
The auricle is innervated by cranial nerves V, VII, X, C2, and C3. The ear canal is innervated by cranial nerves V, VII, and X. The tympanic membrane is innervated by cranial nerves VII, IX, and X. The middle ear is innervated by cranial nerves V, VII, and IX.
Cranial nerves V, VII, IX, X, C2, and C3 also innervate organs outside of the ear, leading to numerous potential causes of referred ear pain.
Cranial nerve V (trigeminal) is composed of the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches. It provides sensory innervation for the face, sinuses, palate, and teeth. The auriculotemporal branch of cranial nerve V innervates the temporomandibular joint (TMJ). This branch is most commonly implicated in temporomandibular joint disease. Dental and TMJ pathology are common secondary causes of otalgia. Cranial nerve VII (facial) innervates the anterior two-thirds of the tongue, sublingual, and submandibular salivary glands. It also innervates the muscles of facial expression. Cranial nerve IX (glossopharyngeal) innervates the posterior third of the tongue, carotid body, and oropharynx. Cranial nerve X (vagus) innervates the sinuses, thyroid gland, pharynx, and larynx. The superior laryngeal branch of the vagus nerve innervates the vocal cords. It also innervates distant organs such as the heart, lung, and parts of the gastrointestinal tract. C2 and C3, which are branches of the cervical plexus, innervate the back of the head, sternocleidomastoid, and cervical paraspinal muscles.
What is the ICD-10 code for ear pain both ears?
What is the ICD-10 code for left otitis externa?A186Tuberculosis of (inner) (middle) ear A360Pharyngeal diphtheria A361Nasopharyngeal diphtheria A362Laryngeal diphtheria A545Gonococcal pharyngitis A564Chlamydial infection of pharynx A665Gangosa A690Necrotizing ulcerative stomatitis A691Other Vincent’s infections B001Herpesviral vesicular dermatitis B002Herpesviral gingivostomatitis and pharyngotonsillitis B053Measles complicated by otitis media B085Enteroviral vesicular pharyngitis B370Candidal stomatitis B3783Candidal cheilitis B3784Candidal otitis externa C000Malignant neoplasm of external upper lip C001Malignant neoplasm of external lower lip C002Malignant neoplasm of external lip, unspecified C003Malignant neoplasm of upper lip, inner aspect C004Malignant neoplasm of lower lip, inner aspect C005Malignant neoplasm of lip, unspecified, inner aspect C006Malignant neoplasm of commissure of lip, unspecified C008Malignant neoplasm of overlapping sites of lip C009Malignant neoplasm of lip, unspecified C01Malignant neoplasm of base of tongue C020Malignant neoplasm of dorsal surface of tongue C021Malignant neoplasm of border of tongue C022Malignant neoplasm of ventral surface of tongue C023Malignant neoplasm of anterior two-thirds of tongue, part unspecified C024Malignant neoplasm of lingual tonsil C028Malignant neoplasm of overlapping sites of tongue C029Malignant neoplasm of tongue, unspecified C030Malignant neoplasm of upper gum C031Malignant neoplasm of lower gum C039Malignant neoplasm of gum, unspecified C040Malignant neoplasm of anterior floor of mouth C041Malignant neoplasm of lateral floor of mouth C048Malignant neoplasm of overlapping sites of floor of mouth C049Malignant neoplasm of floor of mouth, unspecified C050Malignant neoplasm of hard palate C051Malignant neoplasm of soft palate C052Malignant neoplasm of uvula C058Malignant neoplasm of overlapping sites of palate C059Malignant neoplasm of palate, unspecified C060Malignant neoplasm of cheek mucosa C061Malignant neoplasm of vestibule of mouth C062Malignant neoplasm of retromolar area C0680Malignant neoplasm of overlapping sites of unspecified parts of mouth C0689Malignant neoplasm of overlapping sites of other parts of mouth C069Malignant neoplasm of mouth, unspecified C07Malignant neoplasm of parotid gland C080Malignant neoplasm of submandibular gland C081Malignant neoplasm of sublingual gland C089Malignant neoplasm of major salivary gland, unspecified C090Malignant neoplasm of tonsillar fossa C091Malignant neoplasm of tonsillar pillar (anterior) (posterior) C098Malignant neoplasm of overlapping sites of tonsil C099Malignant neoplasm of tonsil, unspecified C100Malignant neoplasm of vallecula C101Malignant neoplasm of anterior surface of epiglottis C102Malignant neoplasm of lateral wall of oropharynx C103Malignant neoplasm of posterior wall of oropharynx C104Malignant neoplasm of branchial cleft C108Malignant neoplasm of overlapping sites of oropharynx C109Malignant neoplasm of oropharynx, unspecified C110Malignant neoplasm of superior wall of nasopharynx C111Malignant neoplasm of posterior wall of nasopharynx C112Malignant neoplasm of lateral wall of nasopharynx C113Malignant neoplasm of anterior wall of nasopharynx C118Malignant neoplasm of overlapping sites of nasopharynx C119Malignant neoplasm of nasopharynx, unspecified C12Malignant neoplasm of pyriform sinus C130Malignant neoplasm of postcricoid region C131Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect C132Malignant neoplasm of posterior wall of hypopharynx C138Malignant neoplasm of overlapping sites of hypopharynx C139Malignant neoplasm of hypopharynx, unspecified C140Malignant neoplasm of pharynx, unspecified C142Malignant neoplasm of Waldeyer’s ring C148Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx C300Malignant neoplasm of nasal cavity C301Malignant neoplasm of middle ear C310Malignant neoplasm of maxillary sinus C311Malignant neoplasm of ethmoidal sinus C312Malignant neoplasm of frontal sinus C313Malignant neoplasm of sphenoid sinus C318Malignant neoplasm of overlapping sites of accessory sinuses C319Malignant neoplasm of accessory sinus, unspecified C320Malignant neoplasm of glottis C321Malignant neoplasm of supraglottis C322Malignant neoplasm of subglottis C323Malignant neoplasm of laryngeal cartilage C328Malignant neoplasm of overlapping sites of larynx C329Malignant neoplasm of larynx, unspecified C390Malignant neoplasm of upper respiratory tract, part unspecified C462Kaposi’s sarcoma of palate C760Malignant neoplasm of head, face and neck D0000Carcinoma in situ of oral cavity, unspecified site D0001Carcinoma in situ of labial mucosa and vermilion border D0002Carcinoma in situ of buccal mucosa D0003Carcinoma in situ of gingiva and edentulous alveolar ridge D0004Carcinoma in situ of soft palate D0005Carcinoma in situ of hard palate D0006Carcinoma in situ of floor of mouth D0007Carcinoma in situ of tongue D0008Carcinoma in situ of pharynx D020Carcinoma in situ of larynx D100Benign neoplasm of lip D101Benign neoplasm of tongue D102Benign neoplasm of floor of mouth D1030Benign neoplasm of unspecified part of mouth D1039Benign neoplasm of other parts of mouth D104Benign neoplasm of tonsil D105Benign neoplasm of other parts of oropharynx D106Benign neoplasm of nasopharynx D107Benign neoplasm of hypopharynx D109Benign neoplasm of pharynx, unspecified D110Benign neoplasm of parotid gland D117Benign neoplasm of other major salivary glands D119Benign neoplasm of major salivary gland, unspecified D140Benign neoplasm of middle ear, nasal cavity and accessory sinuses D141Benign neoplasm of larynx D165Benign neoplasm of lower jaw bone D3701Neoplasm of uncertain behavior of lip D3702Neoplasm of uncertain behavior of tongue D37030Neoplasm of uncertain behavior of the parotid salivary glands D37031Neoplasm of uncertain behavior of the sublingual salivary glands D37032Neoplasm of uncertain behavior of the submandibular salivary glands D37039Neoplasm of uncertain behavior of the major salivary glands, unspecified D3704Neoplasm of uncertain behavior of the minor salivary glands D3705Neoplasm of uncertain behavior of pharynx D3709Neoplasm of uncertain behavior of other specified sites of the oral cavity D380Neoplasm of uncertain behavior of larynx G4730Sleep apnea, unspecified G4733Obstructive sleep apnea (adult) (pediatric) G4734Idiopathic sleep related nonobstructive alveolar hypoventilation G4736Sleep related hypoventilation in conditions classified elsewhere G4739Other sleep apnea G4750Parasomnia, unspecified G4752REM sleep behavior disorder G4754Parasomnia in conditions classified elsewhere G4759Other parasomnia G4763Sleep related bruxism G4769Other sleep related movement disorders G478Other sleep disorders H6000Abscess of external ear, unspecified ear H6001Abscess of right external ear H6002Abscess of left external ear H6003Abscess of external ear, bilateral H6010Cellulitis of external ear, unspecified ear H6011Cellulitis of right external ear H6012Cellulitis of left external ear H6013Cellulitis of external ear, bilateral H6020Malignant otitis externa, unspecified ear H6021Malignant otitis externa, right ear H6022Malignant otitis externa, left ear H6023Malignant otitis externa, bilateral H60311Diffuse otitis externa, right ear H60312Diffuse otitis externa, left ear H60313Diffuse otitis externa, bilateral H60319Diffuse otitis externa, unspecified ear H60321Hemorrhagic otitis externa, right ear H60322Hemorrhagic otitis externa, left ear H60323Hemorrhagic otitis externa, bilateral H60329Hemorrhagic otitis externa, unspecified ear H60331Swimmer’s ear, right ear H60332Swimmer’s ear, left ear H60333Swimmer’s ear, bilateral H60339Swimmer’s ear, unspecified ear H60391Other infective otitis externa, right ear H60392Other infective otitis externa, left ear H60393Other infective otitis externa, bilateral H60399Other infective otitis externa, unspecified ear H6040Cholesteatoma of external ear, unspecified ear H6041Cholesteatoma of right external ear H6042Cholesteatoma of left external ear H6043Cholesteatoma of external ear, bilateral H60501Unspecified acute noninfective otitis externa, right ear H60502Unspecified acute noninfective otitis externa, left ear H60503Unspecified acute noninfective otitis externa, bilateral H60509Unspecified acute noninfective otitis externa, unspecified ear H60511Acute actinic otitis externa, right ear H60512Acute actinic otitis externa, left ear H60513Acute actinic otitis externa, bilateral H60519Acute actinic otitis externa, unspecified ear H60521Acute chemical otitis externa, right ear H60522Acute chemical otitis externa, left ear H60523Acute chemical otitis externa, bilateral H60529Acute chemical otitis externa, unspecified ear H60531Acute contact otitis externa, right ear H60532Acute contact otitis externa, left ear H60533Acute contact otitis externa, bilateral H60539Acute contact otitis externa, unspecified ear H60541Acute eczematoid otitis externa, right ear H60542Acute eczematoid otitis externa, left ear H60543Acute eczematoid otitis externa, bilateral H60549Acute eczematoid otitis externa, unspecified ear H60551Acute reactive otitis externa, right ear H60552Acute reactive otitis externa, left ear H60553Acute reactive otitis externa, bilateral H60559Acute reactive otitis externa, unspecified ear H60591Other noninfective acute otitis externa, right ear H60592Other noninfective acute otitis externa, left ear H60593Other noninfective acute otitis externa, bilateral H60599Other noninfective acute otitis externa, unspecified ear H6060Unspecified chronic otitis externa, unspecified ear H6061Unspecified chronic otitis externa, right ear H6062Unspecified chronic otitis externa, left ear H6063Unspecified chronic otitis externa, bilateral H608X1Other otitis externa, right ear H608X2Other otitis externa, left ear H608X3Other otitis externa, bilateral H608X9Other otitis externa, unspecified ear H6090Unspecified otitis externa, unspecified ear H6091Unspecified otitis externa, right ear H6092Unspecified otitis externa, left ear H6093Unspecified otitis externa, bilateral H61001Unspecified perichondritis of right external ear H61002Unspecified perichondritis of left external ear H61003Unspecified perichondritis of external ear, bilateral H61009Unspecified perichondritis of external ear, unspecified ear H61101Unspecified noninfective disorders of pinna, right ear H61102Unspecified noninfective disorders of pinna, left ear H61103Unspecified noninfective disorders of pinna, bilateral H61109Unspecified noninfective disorders of pinna, unspecified ear H61111Acquired deformity of pinna, right ear H61112Acquired deformity of pinna, left ear H61113Acquired deformity of pinna, bilateral H61119Acquired deformity of pinna, unspecified ear H61121Hematoma of pinna, right ear H61122Hematoma of pinna, left ear H61123Hematoma of pinna, bilateral H61129Hematoma of pinna, unspecified ear H61191Noninfective disorders of pinna, right ear H61192Noninfective disorders of pinna, left ear H61193Noninfective disorders of pinna, bilateral H61199Noninfective disorders of pinna, unspecified ear H6120Impacted cerumen, unspecified ear H6121Impacted cerumen, right ear H6122Impacted cerumen, left ear H6123Impacted cerumen, bilateral H61301Acquired stenosis of right external ear canal, unspecified H61302Acquired stenosis of left external ear canal, unspecified H61303Acquired stenosis of external ear canal, unspecified, bilateral H61309Acquired stenosis of external ear canal, unspecified, unspecified ear H61311Acquired stenosis of right external ear canal secondary to trauma H61312Acquired stenosis of left external ear canal secondary to trauma H61313Acquired stenosis of external ear canal secondary to trauma, bilateral H61319Acquired stenosis of external ear canal secondary to trauma, unspecified ear H61321Acquired stenosis of right external ear canal secondary to inflammation and infection H61322Acquired stenosis of left external ear canal secondary to inflammation and infection H61323Acquired stenosis of external ear canal secondary to inflammation and infection, bilateral H61329Acquired stenosis of external ear canal secondary to inflammation and infection, unspecified ear H61391Other acquired stenosis of right external ear canal H61392Other acquired stenosis of left external ear canal H61393Other acquired stenosis of external ear canal, bilateral H61399Other acquired stenosis of external ear canal, unspecified ear H61811Exostosis of right external canal H61812Exostosis of left external canal H61813Exostosis of external canal, bilateral H61819Exostosis of external canal, unspecified ear H61891Other specified disorders of right external ear H61892Other specified disorders of left external ear H61893Other specified disorders of external ear, bilateral H61899Other specified disorders of external ear, unspecified ear H6190Disorder of external ear, unspecified, unspecified ear H6191Disorder of right external ear, unspecified H6192Disorder of left external ear, unspecified H6193Disorder of external ear, unspecified, bilateral H6240Otitis externa in other diseases classified elsewhere, unspecified ear H6241Otitis externa in other diseases classified elsewhere, right ear H6242Otitis externa in other diseases classified elsewhere, left ear H6243Otitis externa in other diseases classified elsewhere, bilateral H628X1Other disorders of right external ear in diseases classified elsewhere H628X2Other disorders of left external ear in diseases classified elsewhere H628X3Other disorders of external ear in diseases classified elsewhere, bilateral H628X9Other disorders of external ear in diseases classified elsewhere, unspecified ear H6500Acute serous otitis media, unspecified ear H6501Acute serous otitis media, right ear H6502Acute serous otitis media, left ear H6503Acute serous otitis media, bilateral H6504Acute serous otitis media, recurrent, right ear H6505Acute serous otitis media, recurrent, left ear H6506Acute serous otitis media, recurrent, bilateral H6507Acute serous otitis media, recurrent, unspecified ear H65111Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), right ear H65112Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), left ear H65113Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), bilateral H65114Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, right ear H65115Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, left ear H65116Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, bilateral H65117Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), recurrent, unspecified ear H65119Acute and subacute allergic otitis media (mucoid) (sanguinous) (serous), unspecified ear H65191Other acute nonsuppurative otitis media, right ear H65192Other acute nonsuppurative otitis media, left ear H65193Other acute nonsuppurative otitis media, bilateral H65194Other acute nonsuppurative otitis media, recurrent, right ear H65195Other acute nonsuppurative otitis media, recurrent, left ear H65196Other acute nonsuppurative otitis media, recurrent, bilateral H65197Other acute nonsuppurative otitis media recurrent, unspecified ear H65199Other acute nonsuppurative otitis media, unspecified ear H6520Chronic serous otitis media, unspecified ear H6521Chronic serous otitis media, right ear H6522Chronic serous otitis media, left ear H6523Chronic serous otitis media, bilateral H6530Chronic mucoid otitis media, unspecified ear H6531Chronic mucoid otitis media, right ear H6532Chronic mucoid otitis media, left ear H6533Chronic mucoid otitis media, bilateral H65411Chronic allergic otitis media, right ear H65412Chronic allergic otitis media, left ear H65413Chronic allergic otitis media, bilateral H65419Chronic allergic otitis media, unspecified ear H65491Other chronic nonsuppurative otitis media, right ear H65492Other chronic nonsuppurative otitis media, left ear H65493Other chronic nonsuppurative otitis media, bilateral H65499Other chronic nonsuppurative otitis media, unspecified ear H6590Unspecified nonsuppurative otitis media, unspecified ear H6591Unspecified nonsuppurative otitis media, right ear H6592Unspecified nonsuppurative otitis media, left ear H6593Unspecified nonsuppurative otitis media, bilateral H66001Acute suppurative otitis media without spontaneous rupture of ear drum, right ear H66002Acute suppurative otitis media without spontaneous rupture of ear drum, left ear H66003Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral H66004Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, right ear H66005Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear H66006Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral H66007Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, unspecified ear H66009Acute suppurative otitis media without spontaneous rupture of ear drum, unspecified ear H66011Acute suppurative otitis media with spontaneous rupture of ear drum, right ear H66012Acute suppurative otitis media with spontaneous rupture of ear drum, left ear H66013Acute suppurative otitis media with spontaneous rupture of ear drum, bilateral H66014Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, right ear H66015Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, left ear H66016Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, bilateral H66017Acute suppurative otitis media with spontaneous rupture of ear drum, recurrent, unspecified ear H66019Acute suppurative otitis media with spontaneous rupture of ear drum, unspecified ear H6610Chronic tubotympanic suppurative otitis media, unspecified H6611Chronic tubotympanic suppurative otitis media, right ear H6612Chronic tubotympanic suppurative otitis media, left ear H6613Chronic tubotympanic suppurative otitis media, bilateral H6620Chronic atticoantral suppurative otitis media, unspecified ear H6621Chronic atticoantral suppurative otitis media, right ear H6622Chronic atticoantral suppurative otitis media, left ear H6623Chronic atticoantral suppurative otitis media, bilateral H663X1Other chronic suppurative otitis media, right ear H663X2Other chronic suppurative otitis media, left ear H663X3Other chronic suppurative otitis media, bilateral H663X9Other chronic suppurative otitis media, unspecified ear H6640Suppurative otitis media, unspecified, unspecified ear H6641Suppurative otitis media, unspecified, right ear H6642Suppurative otitis media, unspecified, left ear H6643Suppurative otitis media, unspecified, bilateral H6690Otitis media, unspecified, unspecified ear H6691Otitis media, unspecified, right ear H6692Otitis media, unspecified, left ear H6693Otitis media, unspecified, bilateral H671Otitis media in diseases classified elsewhere, right ear H672Otitis media in diseases classified elsewhere, left ear H673Otitis media in diseases classified elsewhere, bilateral H679Otitis media in diseases classified elsewhere, unspecified ear H68001Unspecified Eustachian salpingitis, right ear H68002Unspecified Eustachian salpingitis, left ear H68003Unspecified Eustachian salpingitis, bilateral H68009Unspecified Eustachian salpingitis, unspecified ear H68011Acute Eustachian salpingitis, right ear H68012Acute Eustachian salpingitis, left ear H68013Acute Eustachian salpingitis, bilateral H68019Acute Eustachian salpingitis, unspecified ear H68021Chronic Eustachian salpingitis, right ear H68022Chronic Eustachian salpingitis, left ear H68023Chronic Eustachian salpingitis, bilateral H68029Chronic Eustachian salpingitis, unspecified ear H68101Unspecified obstruction of Eustachian tube, right ear H68102Unspecified obstruction of Eustachian tube, left ear H68103Unspecified obstruction of Eustachian tube, bilateral H68109Unspecified obstruction of Eustachian tube, unspecified ear H68111Osseous obstruction of Eustachian tube, right ear H68112Osseous obstruction of Eustachian tube, left ear H68113Osseous obstruction of Eustachian tube, bilateral H68119Osseous obstruction of Eustachian tube, unspecified ear H68121Intrinsic cartilagenous obstruction of Eustachian tube, right ear H68122Intrinsic cartilagenous obstruction of Eustachian tube, left ear H68123Intrinsic cartilagenous obstruction of Eustachian tube, bilateral H68129Intrinsic cartilagenous obstruction of Eustachian tube, unspecified ear H68131Extrinsic cartilagenous obstruction of Eustachian tube, right ear H68132Extrinsic cartilagenous obstruction of Eustachian tube, left ear H68133Extrinsic cartilagenous obstruction of Eustachian tube, bilateral H68139Extrinsic cartilagenous obstruction of Eustachian tube, unspecified ear H6900Patulous Eustachian tube, unspecified ear H6901Patulous Eustachian tube, right ear H6902Patulous Eustachian tube, left ear H6903Patulous Eustachian tube, bilateral H6980Other specified disorders of Eustachian tube, unspecified ear H6981Other specified disorders of Eustachian tube, right ear H6982Other specified disorders of Eustachian tube, left ear H6983Other specified disorders of Eustachian tube, bilateral H6990Unspecified Eustachian tube disorder, unspecified ear H6991Unspecified Eustachian tube disorder, right ear H6992Unspecified Eustachian tube disorder, left ear
What is the ICD for disease of left inner ear?MDC 03 Diseases & Disorders of the Ear, Nose, Mouth & Throat Disequilibrium H8101Meniere’s disease, right ear H8102Meniere’s disease, left ear H8103Meniere’s disease, bilateral H8109Meniere’s disease, unspecified ear H8110Benign paroxysmal vertigo, unspecified ear H8111Benign paroxysmal vertigo, right ear H8112Benign paroxysmal vertigo, left ear H8113Benign paroxysmal vertigo, bilateral H8120Vestibular neuronitis, unspecified ear H8121Vestibular neuronitis, right ear H8122Vestibular neuronitis, left ear H8123Vestibular neuronitis, bilateral H81311Aural vertigo, right ear H81312Aural vertigo, left ear H81313Aural vertigo, bilateral H81319Aural vertigo, unspecified ear H81391Other peripheral vertigo, right ear H81392Other peripheral vertigo, left ear H81393Other peripheral vertigo, bilateral H81399Other peripheral vertigo, unspecified ear H8141Vertigo of central origin, right ear H8142Vertigo of central origin, left ear H8143Vertigo of central origin, bilateral H8149Vertigo of central origin, unspecified ear H818X1Other disorders of vestibular function, right ear H818X2Other disorders of vestibular function, left ear H818X3Other disorders of vestibular function, bilateral H818X9Other disorders of vestibular function, unspecified ear H8190Unspecified disorder of vestibular function, unspecified ear H8191Unspecified disorder of vestibular function, right ear H8192Unspecified disorder of vestibular function, left ear H8193Unspecified disorder of vestibular function, bilateral H821Vertiginous syndromes in diseases classified elsewhere, right ear H822Vertiginous syndromes in diseases classified elsewhere, left ear H823Vertiginous syndromes in diseases classified elsewhere, bilateral H829Vertiginous syndromes in diseases classified elsewhere, unspecified ear H8301Labyrinthitis, right ear H8302Labyrinthitis, left ear H8303Labyrinthitis, bilateral H8309Labyrinthitis, unspecified ear H832X1Labyrinthine dysfunction, right ear H832X2Labyrinthine dysfunction, left ear H832X3Labyrinthine dysfunction, bilateral H832X9Labyrinthine dysfunction, unspecified ear H838X1Other specified diseases of right inner ear H838X2Other specified diseases of left inner ear H838X3Other specified diseases of inner ear, bilateral H838X9Other specified diseases of inner ear, unspecified ear H8390Unspecified disease of inner ear, unspecified ear H8391Unspecified disease of right inner ear H8392Unspecified disease of left inner ear H8393Unspecified disease of inner ear, bilateral R42Dizziness and giddiness T753XXAMotion sickness, initial encounter
What is the ICD-10 code for ear pain?
ICD-10 code H92.09 for Otalgia, unspecified ear is a medical classification as listed by WHO under the range – Diseases of the ear and mastoid process.
Is otalgia an ear infection?
Ear Pain: Diagnosing Common and Uncommon Causes Patients with otalgia (ear pain) commonly present to their primary care physician. Pain that originates from the ear is known as primary otalgia, whereas pain that originates outside the ear is secondary otalgia.
- A comprehensive history and physical examination are essential to determine the etiology of primary or secondary otalgia.
- Primary otalgia is more common in children, whereas secondary otalgia is more common in adults.
- The etiology of primary otalgia, which is usually identified on examination of the ear, is typically otitis externa or otitis media.
The etiology of secondary otalgia is more complex because the nerves innervating the ear have a shared distribution to include the head, neck, chest, and abdomen, (), The ear is innervated by several sensory nerves. The auricle is affected by cranial nerves V, VII, X, C2, and C3; the external auditory meatus and canal by cranial nerves V, VII, and X; the tympanic membrane by cranial nerves VII, IX, and X; and the middle ear by cranial nerves V, VII, and IX. To determine the differential diagnosis of otalgia, the following factors should be considered: pain location, duration, aggravating factors, alleviating factors, associated symptoms, previous episodes, medical history, smoking status, and alcohol abuse.
- Symptoms such as otorrhea, tympanic membrane fullness, and vertigo suggest primary otalgia, – whereas pain with chewing, sinusitis, dental procedures, and a history of gastroesophageal reflux suggest secondary otalgia.
- In adults, the absence of hearing loss is a cardinal finding associated with nonotologic disease.
The character of pain also provides important clues. Pain that is continuous and progressively worsens is more likely to be associated with infection and primary otalgia. Intermittent pain is likely to be associated with secondary otalgia. The physician should start the examination by asking the patient to localize the pain, which may reveal a secondary cause (e.g., localization to the temporomandibular joint, myofascial pain localized to the mastoid process).
Physical examination should include inspection of the auricle and periauricular region, as well as an otoscopic examination to visually inspect the tympanic membrane and the external auditory canal. Specific otoscopic examination findings for the etiology of otalgia are listed in, and,, Detection of a middle ear effusion with moderate to severe bulging of the tympanic membrane, new-onset otorrhea not caused by otitis externa, or mild bulging of the tympanic membrane with recent onset of ear pain (less than 48 hours), especially with erythema, is key in the diagnosis of acute otitis media.
The tympanic membrane is normally mobile, translucent, and intact. A tympanic membrane that has normal color and mobility is not typical for acute otitis media. Patients with otitis externa typically have pain, redness, swelling, and inflammation along the external auditory canal. The examination also includes traction on the auricle and palpation of the tragus to differentiate disease processes affecting the external ear and ear canal (most commonly otitis externa). Finding vesicles in the ear canal or on the external ear may indicate herpes zoster oticus (Ramsay Hunt syndrome).
If the auricular examination is unremarkable, a complete head and neck examination should also be performed, paying special attention to the TMJ and the nasal and oral cavities. TMJ syndrome commonly presents with discomfort or crepitus on palpation of the TMJ. A variety of dental causes of otalgia can be identified by evaluating the oral cavity with palpation and percussion of the gum line and teeth, specifically the molars.
Evaluation of the oropharynx may also result in findings diagnostic of pharyngitis and other oropharyngeal disorders that can radiate pain to the ear. Patients with abnormal vital signs who present initially with otalgia may have a serious infection, such as meningitis or sepsis, or serious traumatic injury, such as epidural hematoma.
- Patients with ear pain and abnormal mental status must be evaluated for traumatic injury, epidural infection, and osteomyelitis.
- The diagnosis of primary otalgia rarely requires more than a history and physical examination (),
- Likewise, most cases of secondary otalgia can be diagnosed with a history and physical examination.
Concerning historical features include progressive or unrelenting symptoms, unintentional weight loss, exertional pain, behavioral risk factors (e.g., tobacco exposure, heavy alcohol consumption), medical history (e.g., immunocompromised state, coronary artery disease, cancer, diabetes mellitus), and new-onset symptoms in patients 50 years or older.
- When the physical examination is unremarkable (especially if there are concerning historical features), nasolaryngoscopy, tympanometry, audiometry, and laboratory evaluation with a complete blood count and erythrocyte sedimentation rate can be helpful.
- Magnetic resonance imaging, computed tomography, and, if there is a history of cancer, positron emission tomography may be performed to provide further information.
,, – Advanced imaging for evaluation of otalgia may be most efficiently ordered in consultation with an otolaryngologist. Primary otalgia can be further delineated into pain originating from the external ear, ear canal, or middle ear (),, External ear pain can be due to several factors, including trauma, sunburn, acute folliculitis, contact dermatitis, shingles, and other skin conditions.
- When trauma is suspected, the temporal and parietal regions of the skull should be assessed and appropriate imaging ordered.
- Disorders of the external auditory canal that may cause pain include cerumen impaction, foreign bodies, and, most commonly, infection of the canal.
- Otitis externa (commonly known as swimmer’s ear) is caused by bacterial infections (90%) and fungal infections (10%).
, Ear pain originating in the middle ear is typically due to acute otitis media, but can also be from bullous myringitis, barotrauma, and eustachian tube dysfunction. Otitis media is most commonly caused by Streptococcus pneumoniae, Moraxella catarrhalis, or Haemophilus influenzae,
- Eustachian tube dysfunction is also a common cause of primary otalgia, affecting an estimated 3% of patients presenting with otalgia.
- A consensus definition of eustachian tube dysfunction is signs and symptoms of pressure dysregulation in the middle ear diagnosed with otoscopic evidence of tympanic membrane retraction and/or tympanogram indicating negative middle ear pressure.
Bullous myringitis is uncommon, but occurs when serous or hemorrhagic blisters form in the ear canal or on the lateral tympanic membrane (usually caused by a bacterial or viral infection); symptoms generally include sudden onset of severe ear pain and hearing loss.
- Pain often decreases after bullae rupture and drain.
- Uncommon causes of primary otalgia include infectious, neoplastic, and inflammatory etiologies.
- Mastoiditis, an infection in the air cells of the skull behind the ear, is a rare complication from acute otitis media.
- This diagnosis is based on physical examination findings of tenderness, erythema, edema, and warmth in the mastoid region.
Malignant otitis externa is a rare condition found in patients with diabetes or who are immunocompromised. It is characterized by severe unrelenting pain and a subtle finding of inferior external auditory canal granulation tissue at the bony cartilaginous junction.
- Pseudomonas infection involving the skull base (osteitis) can result in lower cranial neuropathies.
- Herpes zoster oticus is caused by reactivation of latent herpes zoster infection from the geniculate ganglion (cranial nerve VII or facial nerve), but also can involve cranial nerves V, IX, and X.
- Symptoms include ear pain and facial paralysis while the patient has vesicles in the external auditory canal.
Cholesteatomas may produce a sense of fullness rather than severe pain but may also be asymptomatic. An epidermal cyst develops in the superior, usually posterior, aspect of the tympanic membranes. The cyst can cause conductive hearing loss secondary to local destruction of middle ear structures and may present with otorrhea consisting of desquamating epithelium.
- Relapsing polychondritis is a rare systemic disease involving the cartilage of many organs, but most commonly the ears.
- It is characterized by a relapsing, bilateral, erythematous or violaceous appearance on the external ear, sparing the ear lobes.
- The complex embryologic development of the ear results in neural connections to several cranial and cervical nerves.
These nerves provide sensory innervation to regions of the head, neck, chest, and abdomen, which can result in referred pain to the ear ( and, ), Referred pain from the trigeminal nerve (cranial nerve V) is the most common source of secondary otalgia stemming from TMJ syndrome, dental infections, trigeminal neuralgia, sinusitis, and mandibular osteomyelitis or tumor.
- Herpes zoster can affect cranial nerve VII to a lesser degree than in Ramsay Hunt syndrome, which can also cause ear pain associated with Bell palsy and an unremarkable ear examination.
- Cranial nerve IX can refer pain caused by tonsillitis, pharyngitis, pharyngeal tumor, or glossopharyngeal neuromas.
The vagus nerve affects many systems as inferior as the colon and can be activated by any vagal stimulation. Otalgia has been reported as the presenting symptom of myocardial ischemia from irritation of the vagus nerve. Secondary otalgia can be caused by irritation of C2 and C3 cervical nerve roots, especially in patients with cervical spine degeneration.
Tumor, infection, or an inflammatory process within the sensory distribution of any of these nerves may cause referred pain to the ear. An example of this is temporal arteritis, which presents with temporal pain in only 40% of patients. Temporal arteritis should be considered in patients 50 years or older who have normal ear examination findings and any of the following symptoms: headache, malaise, weight loss, fever, or anorexia.
Permanent blindness may result if systemic steroids are not initiated promptly. In suspected cases, an elevated erythrocyte sedimentation rate (50 mm per hour or greater) warrants immediate treatment with systemic steroids and surgical consultation to confirm the diagnosis.
What is ICD-9 for ear pain?
ICD-9 code 388.70 for Otalgia unspecified is a medical classification as listed by WHO under the range -DISEASES OF THE EAR AND MASTOID PROCESS (380-389).
What is the ICD-10 for something in ear?
ICD-10 code T16 for Foreign body in ear is a medical classification as listed by WHO under the range – Injury, poisoning and certain other consequences of external causes.
What is the ICD-10 code for ear check?
ICD-10 code Z01.10 for Encounter for examination of ears and hearing without abnormal findings is a medical classification as listed by WHO under the range – Factors influencing health status and contact with health services.
What is the ICD-10 code for chronic ear infection?
Chronic serous otitis media, unspecified ear –
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code
- H65.20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- The 2023 edition of ICD-10-CM H65.20 became effective on October 1, 2022.
- This is the American ICD-10-CM version of H65.20 – other international versions of ICD-10 H65.20 may differ.
The following code(s) above H65.20 contain annotation back-references Annotation Back-References In this context, annotation back-references refer to codes that contain:
- Applicable To annotations, or
- Code Also annotations, or
- Code First annotations, or
- Excludes1 annotations, or
- Excludes2 annotations, or
- Includes annotations, or
- Note annotations, or
- Use Additional annotations
that may be applicable to H65.20 :
- H60-H95 2023 ICD-10-CM Range H60-H95
What is otitis externa caused by?
Common causes – Causes of otitis externa can include:
- a bacterial infection – usually by bacteria called Pseudomonas aeruginosa or Staphylococcus aureus seborrheic dermatitis – a common skin condition where the naturally greasy areas of your skin become irritated and inflamed, which can sometimes affect the ears a middle ear infection (otitis media) – discharge produced by an infection deeper in the ear can sometimes lead to otitis externa a fungal infection – such as from the Aspergillus variety and the Candida albicans variety (which also causes thrush); fungal infections are more common if you use antibacterial or steroid ear drops for a long time irritation or an allergic reaction – otitis externa can occur because of a reaction to something that comes into contact with your ears, such as ear medication, ear plugs, shampoo or sweat
Otitis externa can also return after previous treatment if you don’t complete the full course of recommended treatment.
What causes serous otitis media?
Otitis Media with Effusion (OME) Otitis media with effusion (OME) is a collection of non-infected fluid in the middle ear space. It is also called serous or secretory otitis media (SOM). This fluid may accumulate in the middle ear as a result of a cold, sore throat or upper respiratory infection.
- OME is usually self-limited, which means, the fluid usually resolves on its own within 4 to 6 weeks.
- However, in some instances the fluid may persist for a longer period of time and cause a temporary decrease in hearing or the fluid may become infected (acute otitis media).
- OME is more common in children between 6 months and 3 years of age and affects more boys than girls.
The condition occurs more often in the fall and winter months and is commonly underdiagnosed because of its lack of acute or obvious symptoms (compared to acute otitis media). Otitis media with effusion is usually a result of poor function of the eustachian tube, the canal that links the middle ear with the throat area.
An immature eustachian tube, which is common in young children An inflammation of the adenoids A cold or allergy, which can lead to swelling and congestion of the lining of the nose, throat and eustachian tube (this swelling prevents the normal flow of air and fluids) A malformation of the eustachian tube
While any child may develop OME, the following are some of the factors that may increase your child’s risk of developing OME:
Having a cold Spending time in a daycare setting Being bottle fed while lying on the back Being around someone who smokes Absence of breastfeeding History of ear infections Craniofacial abnormalities (e.g. cleft palate)
While signs of OME can vary from child to child and change in intensity, common symptoms include:
Hearing difficulties Tugging or pulling at one or both ears Loss of balance Delayed speech development
Symptoms of OME may resemble other conditions or medical problems. Always see your child’s physician for an accurate diagnosis and to discuss treatment options. If you suspect your child may have OME, you should schedule an appointment with your child’s pediatrician.
- At your child’s appointment, the physician will review the child’s medical history and complete a physical examination of your child including inspecting the outer ear(s) and eardrum(s) using an otoscope.
- The otoscope is a lighted instrument that allows the physician to see inside the ear.
- A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.
In addition, a hearing test may be ordered. The hearing levels and the findings on tympanometry may help to diagnose OME. The picture below represents the typical appearance of OME. This is what your doctor will be seeing when using an otoscope. Add OME picture.
What is the ICD-10 code for left ear cyst?
ICD-10 code Q18.1 for Preauricular sinus and cyst is a medical classification as listed by WHO under the range – Congenital malformations, deformations and chromosomal abnormalities.
What disease affects the ears?
Overview – Meniere’s disease is an inner ear problem that can cause dizzy spells, also called vertigo, and hearing loss. Most of the time, Meniere’s disease affects only one ear. Meniere’s disease can happen at any age. But it usually starts between the ages of 40 to 60.
What is ear disorder ICD-9?
DISEASES OF THE EAR AND MASTOID PROCESS ICD-9 Code range 380-389. The ICD-9 code range DISEASES OF THE EAR AND MASTOID PROCESS for 380-389 is medical classification list by the World Health Organization (WHO).
Why does my left side ear hurt?
What causes ear aches? Ear infections are a common cause of ear pain, especially in children. Other causes include allergies, sinus infections, tooth infections, earwax buildup, altitude changes, and temporomandibular joint (TMJ) syndrome.
What is pain in the ear called?
Otalgia ; Pain – ear; Ear pain.
Why is my left ear hurting so much?
Parents know how common earaches are in children, but adults can get frequent ear pain, too. You don’t have to have an infection, or even anything wrong with your ears, to have ear pain. These are the most common causes: Your ear makes and gets rid of wax all the time.
- When the process doesn’t work well, the gunk builds up and hardens so your ear canal gets blocked.
- Your doctor will call this impacted wax.
- Sometimes, it causes pain,
- Don’t use cotton swabs or other objects to try to get wax out.
- You’ll just push it farther into your ear canal and make it more likely to get impacted.
Your ear might hurt, itch, discharge gunk, or get infected. You could even lose your hearing for a while. You can treat mildly impacted ears at home with over-the-counter ear drops that soften the wax so it can naturally drain. Or go see your doctor if the wax has hardened.
- She can get the wax out without damaging the eardrum.
- Learn more about earwax,
- Most of the time, your ear does a great job of keeping pressure equal on both sides of your eardrum.
- That little pop you feel when you swallow is part of the process.
- But quick changes, like when you’re on an airplane or in an elevator, can throw off the balance.
Your ear might hurt, and you could have trouble hearing. This is typically a eustachian tube dysfunction which can be a chronic in some people. To avoid problems on a plane:
Chew gum, suck on hard candy, or yawn and swallow during takeoff and landing.Stay awake while the plane descends.Take a deep breath, pinch your nostrils shut, then gently try to blow air out of your nose.Avoid air travel and diving when you have a cold, a sinus infection, or allergy symptoms,
Learn more about air pressure and your ears, If your ear hurts when you pull on your earlobe or push on the tiny flap that closes it, you probably have this outer ear infection, You get it when water trapped in your ear canal begins to breed germs. Your ear might get red, swollen, or itch and leak pus.
- It isn’t contagious.
- To avoid it, keep your ears dry during and after swimming.
- Your doctor will probably prescribe antibiotic ear drops to clear it up.
- Learn more about swimmer’s ear,
- A cold, allergies, or a sinus infection can block the tubes in your middle ear.
- When fluid builds up and gets infected, your doctor will call it otitis media,
This is the most common cause of ear pain. If your doctor thinks the cause is a bacteria, she may prescribe antibiotics. If not, then she may recommend a decongestant allergy treatment with an antihistamine and a nasal steroid. Let her know if your pain doesn’t improve or returns.
If it isn’t treated, a middle ear infection can spread or cause hearing loss, Learn more about ear infection treatments, You may feel pain in your ears even when the source is somewhere else in your body, like a toothache, That’s because the nerves in your face and neck pass very close to your inner ear.
Doctors call this type of pain that starts in one area but is felt in another “referred pain.” If your earache comes with a severe sore throat, it could be an infection like tonsillitis or pharyngitis, In fact, ear pain is often the worst symptom of one of these conditions.
- Learn more about sore throat symptoms,
- Tooth abscesses, cavities, and impacted molars also can cause ear pain.
- Your doctor will be able to tell if your teeth are to blame by tapping on a tooth or your gums to see if they feel sore.
- Learn more about toothaches,
- The temporomandibular joint, or TMJ, is the “hinge” of your jaw that sits directly below your ears.
You might get TMJ pain from grinding your teeth, or it could be a symptom of arthritis, The ache in your ears or face comes after you chew, talk, or yawn. To treat it, take over-the-counter pain medicine and put warm compresses on your jaw. Try not to clench your teeth.
What causes of otalgia?
Aetiology – The aetiology of otalgia can be broadly divided into primary and secondary causes (Table 2). Primary causes are those that originate in the ear and are a direct cause of pain through stimulation of nociceptor fibres. Secondary causes are those that the patient feels have originated from the ear, but in fact are referred from other sources and require a higher index of suspicion to determine the precise aeitiology.
Table 2. Causes of otalgia
Primary otalgia Secondary otalgia Infection Dental inflammation and infection 10,11 Trauma and foreign bodies Temporomandibular joint disorders 12,13 Impacted cerumen 8 Trigeminal neuralgia 2 Otologic neoplasms 9 Head and neck cancer 14 Eagle’s syndrome 15 Temporal arteritis
The primary causes of otalgia are often benign and present as straightforward cases to the experienced GP. Infection, trauma, foreign bodies and impacted cerumen are the common conditions usually diagnosed on otoscopy. Primary neoplasms of the ear are rare and usually clearly identified when they occur on the auricle and originate in the peri-auricular region.
Cancers of the temporal bone and external auditory canal are rarer still, and are often only diagnosed when more advanced signs appear, but should be considered in a patient with otalgia and a chronic ear discharge.16 Skull-base osteomyelitis (or malignant otitis externa) should always be considered in patients who are immunosuppressed or have diabetes with severe otalgia and a history of otitis externa.
The organisms typically responsible include Pseudomonas but may also be fungal. The pain is often described as severe and throbbing in nature that radiates into the jaw. As the disease progresses, it causes cranial nerve palsies, initially involving VII (facial nerve), then XII (hypoglossal nerve) and X (vagus nerve).
There is typically granulation tissue seen in the floor of the ear canal. This should be biopsied by an ear, nose and throat (ENT) surgeon as the differential diagnosis is squamous cell carcinoma of the temporal bone. Herpes zoster oticus (Ramsay Hunt syndrome) viral infection presents with pain, vesicles involving pinna/external auditory meatus and facial nerve palsy.
If the cause is not obvious, secondary causes of ear pain are considered. Odontogenic causes are an extremely common cause of referred otalgia; these causes occur in up to 63% of cases 10,11 and include inflammation and infection of dental structures, particularly associated with the posterior teeth.11 Temporomandibular joint (TMJ) disorders are another important cause of secondary otalgia and some patients with TMJ disorders may also present with other otological symptoms such as tinnitus and vertigo.12 The pain of TMJ disorders reflects either the joint or muscles associated with jaw movement; therefore, exacerbation of pain associated with chewing may indicate the source of pain.13 A brief examination of the teeth and jaw may allow commencement of basic management and avoid over-investigation.
Trigeminal neuralgia can also present with otalgia.4 This diagnosis is usually clear; however, when the patient describes unilateral attacks of pain that commence abruptly, last up to two minutes and are extremely excruciating.17 It is reported that neuralgia can occur in other cranial nerves and the consistent feature is that the pain should follow the distribution of the nerve.
All cancers of the head and neck – usually squamous cell carcinomas – need to be considered as a secondary cause of otalgia in patients who have an otherwise normal otology history and examination.14 Of particular importance are neoplasms in the oropharyngeal region (soft palate, posterior pharyngeal wall, palatine tonsil or tongue base), which can present with deep, intense otalgia.14 Patients with cancers in this region may have additional symptoms of dysphagia, odynophagia and sore throat, or may be otherwise asymptomatic.
Risk factors include chronic alcohol consumption and tobacco exposure. Cervical lymphadenopathy is a common examination finding as these cancers often present at advanced stages.18 Examining the oropharynx by direct inspection and palpation, as well as the neck, is critical given that an earlier diagnosis will enable a better chance at curative treatment.
A complete examination of the oropharynx does require nasal endoscopy by an otolaryngologist and therefore unexplained otalgia should be referred early. Eagle’s syndrome 15 may be secondary to a calcified stylohyoid ligament, which can be palpable in the tonsillar fossa.
What is an example of otalgia?
Discussion – Otalgia can be classified into 2 types. Otogenic otalgia originates from diseases of the external, middle and inner ear, whereas referred otalgia arises from pathologies outside the ear, The frequency and ratio of these two types of symptoms are dependent on whether patients are seen by otolaryngologists or other physicians.
- In this study, otogenic otalgia was more frequent than referred otalgia, perhaps because these patients were initially examined and treated by otologists.
- Otogenic otalgia may be due to inflammation, mechanical causes, neoplasm, or Eustachian tube dysfunction,
- Infectious causes include furunculosis, infected sebaceous cysts, cellulitis, otitis externa, necrotizing otitis externa, AOM, mastoiditis, petrous apicitis, bullous otitis externa, and bullous myringitis.
Inflammatory causes include chondrodermatitis and relapsing polychondritis. Mechanical causes include traumatic laceration, pinna hematoma, and tympanic membrane perforation. Neoplastic causes include squamous cell carcinoma and adenocarcinoma; and Eustachian tube dysfunctions include those due to otitis media with effusion and chronic otitis media.
- Acute infectious ear disease is the most common cause of primary otalgia.
- Patients with chronic otologic infections, except for chronic myringitis, rarely complain of severe otalgia.
- Thus, another cause, such as acute infection, is likely if chronic otologic infections are accompanied by otalgia,
- The causes of otalgia varied among our patients.
For example, 78% of patients with primary otalgia were diagnosed with acute infectious ear disease, similar to previous results, Referred otalgia may be caused by various mechanisms. Complex sensory innervation of the auricle and external ear originates during the generation of the ear.
Otic cysts are located between pairs of branchial arches, with cyst location resulting in the domination of various cranial nerves. Other organs are also under the control of these sensory nerves, resulting in referred otalgia, Referred otalgia may arise from the inability of the brain to distinguish the origin of pain because neurons starting from visceral and somatic sensation territories ascend to the brain via the same pathway,
Alternatively, miscommunication may occur at the ventral posterior nucleus between the lateral and medial levels of the thalamus. Finally, referred otalgia may be a high-level phenomenon occurring at the cerebral cortex itself, Referred otalgia is associated with the nerve affected.
- For example, the auriculotemporal nerve (cranial nerve V) is affected by temporomandibular joint dysfunction, dental diseases, trigeminal neuralgia, and mandibular osteomyelitis/tumor.
- The posterior auricular nerve (cranial nerve VII) is affected by acoustic neuroma and herpes zoster infection.
- Jacobson’s nerve (cranial nerve IX) is affected by tonsillitis/pharyngitis, sinusitis, pharyngeal tumor, and glossopharyngeal neuroma.
Arnold’s nerve (cranial nerve X) is affected by laryngopharyngeal reflux, cricopharyngeal spasm, and vagal stimulators. The greater auricular (C2) and lesser occipital (C3) nerves are affected by cervical spine degenerative disease, cervical root cysts, Arnold-Chiari type, whiplash, vascular diseases, fibromyalgia, and other psychogenic causes,
- Therefore, a detailed medical history and a physical examination of all parts of the head and neck are required for patients with otalgia,
- The presence of lesions in organs other than the ear in patients who complain of otalgia may delay diagnosis and treatment.
- In this study, we took detailed medical histories, excluding patients for whom it was impossible to get a medical history or for whom medical records were incomplete.
However, one patient (0.4%) diagnosed with nasopharyngeal cancer was included. The only presenting symptom in this patient was otalgia and the physical examination at the first visit included only the ears, nose, and head & neck. Two months later, this patient had progressed to a sore throat along with the symptoms of otitis media.
- Nasal endoscopy revealed a mass in the nasopharynx, with cancer diagnosed after performing CT and biopsy.
- The causes of otalgia differed in children and adults.
- Diseases of the ear were the most common causes of otalgia in children, whereas secondary or referred otalgia was more common in adults,
- The most common causes of primary and secondary otalgia in children are AOM, common colds and other upper respiratory tract infections, otitis externa, foreign bodies, recurrent parotitis, tonsillitis, quinsy, neck abscess, sinusitis/nasal causes, temporomandibular joint dysfunction, dental causes and rare causes,
In this study, AOM was the most frequent cause of otogenic otalgia (50%), followed by chronic otitis media, otitis externa and ear trauma. Referred otalgia usually arose from a disease such as tonsillitis, pharyngitis or rhinosinusitis, accompanied by systemic symptoms.
Children were diagnosed with otogenic otalgia significantly more frequently than adults because the incidence of AOM was higher in children than in adults. Referred otalgia was less common in children than in adults, perhaps because otogenic otalgia is more frequent in children than in adults. In this study otogenic otalgia was more common than referred otalgia in adults; however referred otalgia was more frequent in adults than in children.
This study found that otogenic otalgia was more frequent in men, whereas referred otalgia was more frequent in women. Males may be more likely than females to pick their ears, thus leading to infectious ear diseases and the more frequent occurrence of otogenic otalgia in males.
Further studies will be needed to address this hypothesis. The region, duration, and severity of pain, as well as its sudden or gradual onset, are useful in diagnosing otalgia. Also, it is essential to confirm the pattern of accompanying symptoms. In this study, otologic symptoms, such as ear fullness, hearing disturbance, otorrhea, tinnitus, and dizziness, accompanied otogenic otalgia; whereas rhinorrhea, nasal obstruction, postnasal drip, sore throat, fever, voice change, and reflux symptoms accompanied referred otalgia.
This result is consistent with those of previous reports, In children, otalgia, cough, rhinitis, fever, diarrhea or vomiting are symptoms of AOM, the most commonly diagnosed cause of primary otalgia, The rates of referred otalgia were similar in men and women.
How do you fix otalgia?
Resting in an upright position instead of lying down can reduce pressure in the middle ear. Over-the-counter ear drops can be used to relieve pain, as long as the eardrum has not ruptured. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache.
What causes referred otalgia?
Cranial Nerve V3 – The trigeminal nerve is cited as the most common sensorineural pathway leading to referred otalgia because of the wide sensory “net” that it covers and the type of pathology that occurs within this region.2, 13 V3 innervates the ear via the auriculotemporal branch but also has sensory nerve fibers via the lingual, buccal, and inferior alveolar nerves, which serve to innervate the oral cavity and floor of mouth, lower teeth, palate, mandible including the temporomandibular joint (TMJ), and the 3 major salivary glands ( Fig 2 ).1, 7, 10, 12, 14 Any irritative focus such as tumor, infection, or inflammation of structures within the oral cavity (specifically including the floor of mouth, cheek, anterior tongue, hard palate, and sublingual and submandibular glands), lower teeth, mandible including the TMJ, and parotid glands can all be sites of distant pathology resulting in referred otalgia.1, 10 Primary and referred otalgia pathways of the mandibular nerve (V3). Cranial nerve V is the most frequent pathway for referred otalgia via the auriculotemporal branch of the trigeminal nerve. Reprinted with permission from the American Journal of Clinical Oncology (2003;26:e157–62).
Within the subset of processes affecting V3, dental diseases account for most pathology causing referred otalgia.3 Plain film bite wing radiographs are still the workhorse for dental evaluation because of their superior resolution and low cost compared with conventional CT, 15, 16 but CT can still accurately detect periodontal disease, periapical abscesses, and condensing osteitis if dental radiographs have not been acquired by the referring physician.
Periodontal disease refers to infection around the tooth, which begins at the gum line and burrows down the margin of the tooth to widen the periodontal ligament.15, 16 If progressive enough, it may result in a visible radiolucency on CT surrounding the margins of the tooth.
Periapical abscesses, on the other hand, develop when bacteria burrow through the substance of the tooth by eroding through the enamel, dentin, and neurovascular pulp/root canal to exit the apical foramen.15 Condensing osteitis is the result of an osseous stress response indicated by an area of increased sclerosis surrounding an infected tooth, 16 which itself does not result in referred otalgia but is an indicator of periodontal or periapical infection that can produce referred otalgia.
Unerupted wisdom teeth, erupting teeth, and malocclusion can likewise cause referred otalgia.14 Otalgia is listed as a chief complaint by 70%–78% of patients with TMJ disorders ( Fig 3 ).17, 18 TMJ disorders have a 2–9 times higher prevalence in women than in men and occur in both sexes between 40 and 70 years of age.19, 20 It is unclear whether this is a true reflex referred ear pain secondary to direct impingement of the auriculotemporal nerve, 21, 22 related to masseteric muscle spasm, or secondary to a direct ligamentous connection between the TMJ and middle ear, but 1 or all of these theories may potentially explain TMJ pathology resulting in otalgia.20 Clark et al 19 performed a study at the Mayo Clinic during a 9-year period and found that 164 of 222 patients with bony crepitus had signs of degenerative changes of the condyle, glenoid fossa, and/or articular eminence on plain film. TMJ. Coronal reformatted CT scan demonstrates severe erosion and irregularity involving the head of the left condylar process. TMJ disease has been well documented to be associated with referred otalgia via the auriculotemporal and masseteric branches of V3. Parotid malignancy. Positron-emission tomography image demonstrates abnormal hypermetabolic activity involving the left prestyloid parapharyngeal region. The corresponding anatomic images demonstrate a calcified mass within the deep lobe of the parotid gland.
- The parotid branches of the auriculotemporal nerve mediate referred otalgia.
- Cancer or ulceration of the anterior tongue, from a process such as aphthous ulcers, can likewise cause otalgia.
- These entities will typically be diagnosed by physical examination.1 Cross-sectional imaging becomes very useful in determining the local and distant spread of neoplastic disease.
Important staging parameters include depth of tongue invasion, spread across the midline lingual septum, and nodal disease.25