Chronic Secondary Otalgia: Multidisciplinary Evaluation and Relationship with Cervical Spine Disease

Objective: We developed an algorithm to evaluate secondary otalgia and examined the role of cervical spine disease in chronic secondary otalgia. Otalgia may arise from the ear itself (primary) or may indicate pathologies outside the ear (secondary). Secondary otalgia is a common and complex symptom. Material and methods: We evaluated the etiological factors in 224 patients diagnosed with secondary otalgia from the perspectives of an otolaryngologist, neurologist, and dentist. We recorded data on the pathogenesis of the otalgia, patient age and gender, pain localization and period, and test results. Results: The most frequent causes of chronic secondary otalgia were cervical spine disease (n=110, 49.5%), temporomandibular joint disorders (n=72, 32.1%), and dental pathologies (n=49, 21.9%). Of the patients, 31.3% (n=70) had more than one etiology. The most frequent pathology of cervical spine disease was cervical disc disease (n=90, 40.2%). Conclusion: On considering secondary otalgia, in must first be separated into acute versus chronic. Cervical spine disease is the most common cause of chronic otalgia, but it is necessary to consider the possible existence of more than one pathology and request routine neurological and dental consultations.