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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Otalgia is the sensation of pain in the ear, while referred otalgia is pain felt in the ear but originating from a nonotologic source. The rich sensory innervation of the ear derives from four cranial nerves and two cervical nerves which also supply other areas in the head, neck, thorax, and abdomen. Pain referred to the ear may originate in areas far removed from the ear itself. Neoplastic, infectious, inflammatory, musculoskeletal, and vascular disorders must all be considered when evaluating the patient with otalgia and a normal ear examination. Otalgia is frequently the presenting complaint in patients with carcinoma of the oropharynx or hypopharynx. This article reviews the anatomic basis for referred otalgia and overviews the common etiologies responsible for this symptom.
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PMID:Referred otalgia. 236 65

The purpose of this study was to determine if the intraoral vertical ramus osteotomy is an effective treatment for anterior disk displacements with reduction and associated temporomandibular joint pain and dysfunction. Success with this procedure was predicated on producing a more functional articular disk-condyle relationship by anterior and inferior repositioning of the condyle. The prospective study was undertaken of nine (eight female and one male) patients (mean age of 25.8 years) with anterior disk displacement with reduction and associated temporomandibular joint pain and dysfunction (mean duration of pain of 6.8 years). History, clinical dysfunction, and pain indices were used to determine the frequency and severity of temporomandibular joint dysfunction. The incidence of ear pain, muscle fatigue, tinnitus, headaches, and clicking was also assessed. The severity of the pain experience in the masticatory muscles and temporomandibular joints was evaluated through the use of a pain index. The severity of the pain experience and temporomandibular joint dysfunction in all of the patients was significantly reduced or totally eliminated during the period of followup. Surgical treatment of anterior disk displacement with reduction by intraoral vertical ramus osteotomy resulted in improved temporomandibular joint function and resolution of symptoms.
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PMID:Treatment of temporomandibular joint dysfunction by intraoral vertical ramus osteotomy. 237 14

The authors used ionophoresis applied with an apparatus of own design in 32 patients with posttraumatic changes in the temporomandibular joints. In 24 cases xylocaine and in 8 cases hydrocortisone were used. In 27 cases disappearance of pain was achieved and complications were not observed. The apparatus of own design was applied also for analgesia for operations on the middle ear through the external meatus, and in the treatment of ear buzzing and otalgia of unknown origin.
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PMID:[Results of treatment with ionophoresis of posttraumatic changes of temporomandibular joints with an apparatus of own design]. 264 Nov 60

Three patients with referred otalgia and/or oropharyngeal pain due to ectopic facial hair found in either the external auditory canal or oropharynx were treated at the Cleveland Clinic Foundation, Department of Otolaryngology and Communicative Disorders. In each of these patients, annoying symptoms were relieved by simple removal of the misplaced facial hair. Sensory nerve innervation of the external ear and oropharynx and their interrelationship in referred pain are described in detail following the case reports.
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PMID:Facial fuzz and funny findings. Facial hair causing otalgia and oropharyngeal pain. 274 48

The clinical and radiologic findings in 30 patients who sustained injuries to the temporomandibular joint (TMJ) were retrospectively analyzed. Imaging consisted of variable combinations of radiography, tomography, two-compartment arthrography, computed tomography, and magnetic resonance imaging and was performed 2 days to 24 months after injury. Indications for imaging included acquired and/or unstable occlusal disturbances, cephalalgia, facial pain, otalgia, TMJ pain, tinnitus, dizziness, hearing disturbance, masticatory dysfunction, and muscle atrophy. Radiologic findings included internal derangement of the TMJ meniscus, swelling of retrodiskal tissues, joint effusion, mandibular condyle and condylar neck fractures, osteochondritis dissecans, avascular necrosis, degenerative condylar remodeling, osteoarthritis, musculotendinous injuries, and atrophy of masticatory muscles. After imaging studies, seven patients underwent surgery, at which time imaging findings were confirmed; one patient underwent successful aspiration of a painful hemarthrosis. TMJ injuries may result in joint derangement, radiologically demonstrable joint degeneration, masticatory muscle dysfunction, pain, and progressive clinical disability.
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PMID:Temporomandibular joint injuries. 278 Oct 10

Between 1983 and 1988, a percutaneous trigeminal ganglion compression (PTGC) procedure for trigeminal neuralgia was performed on 22 patients. All patients were initially relieved of their pain. There were three recurrences (14%); two of these patients underwent a second PTGC procedure and one a partial trigeminal nerve root section. Follow-up examination 3 to 53 months after the procedure showed that all patients were free of pain. Morbidity included persistent minor hypesthesia in five patients, persistent minor dysesthesias in three, persistent minor weakness in three, aseptic meningitis in one, transient sixth nerve palsy in one, and transient otalgia in three. None of the patients had either anesthesia dolorosa or an absent corneal reflex.
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PMID:Percutaneous trigeminal ganglion compression for trigeminal neuralgia. Experience in 22 patients and review of the literature. 278 81

General agreement was found among the 75 patients' responses to the anamnestic questionnaire compared with responses in similar epidemiologic studies. An SPO has been proposed as a method of describing condylar position in addition to the MLD and the index of intercuspal asymmetry (described in Part I). The index of asymmetry was statistically significant at the 0.01 level between the group of 38 patients without primary symptoms and the group of 37 patients with one or more primary symptoms and mandibular dysfunction. The SPO hypothesis that the symptom of noise from the TMJ was present outside the SPO and absent inside the SPO was statistically significant in the categories of primary symptoms, oral habits, and psychologic self-evaluation (p less than 0.01) but was not statistically significant in regard to questions of mandibular function and chronic pain. A composite order of symptoms, determined by the sum of their rankings in each of three condylar indexes, places noise from the TMJ, facial pain, ear pain, chewing pain, and TMJ pain symptoms at the top of the list. The right and left side least squares linear analysis of 38 dental patients without primary symptoms yielded a difference of 10 degrees whereas a greater spread of 69.2 degrees was found in the group of 37 dental patients with primary symptoms and patients with mandibular dysfunction. Patients seen because of mandibular dysfunction present condylar recordings outside the SPO with a high level of agreement and a mean index of intercuspal asymmetry of 1.29 mm (SD 0.570). The three-dimensional analysis of condylar position in RCP and intercuspal position offers an explanation of why the correlation of mandibular dysfunction and occlusion has been difficult to recognize.
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PMID:Condylar retruded contact position and intercuspal position in dentulous patients. Part II: Patients classified by anamnestic questionnaire. 346 92

Tonsillectomy continues to be a commonly performed operation in the pediatric age group. The postoperative period is often protracted and characterized by throat and ear pain, intermittent fever, foul odor from the oral cavity, and poor oral intake. Consequently, antibiotics are frequently prescribed in an effort to minimize these symptoms and/or avoid complications such as dehydration or secondary infection of the operative site. However, to our knowledge, no study to date has been performed to demonstrate the efficacy of antibiotic therapy in this setting. At the Children's Hospital of Philadelphia, a prospective, randomized, double-blind study was undertaken in which ampicillin (or placebo) was administered intravenously at the time of surgery and for 12 to 24 hours postoperatively. The children then continued to receive oral amoxicillin therapy (or placebo) for an additional seven days. The patients were then evaluated for the incidence and severity of postoperative symptoms and complications. Intraoperative cultures of the oropharynx and tonsillar tissue, as well as cultures of the tonsillar fossa, were obtained following completion of one week of therapy. Our results indicate that ampicillin sodium/amoxicillin trihydrate therapy is well tolerated and safe in the nonallergic child and is effective in minimizing fever and other troublesome postoperative symptoms, such as pain, lassitude, mouth odor, and poor oral intake after tonsillectomy.
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PMID:The effect of antibiotic therapy on recovery after tonsillectomy in children. A controlled study. 351 77

The use of benzydamine hydrochloride pump spray as a post-operative analgesic in children undergoing tonsillectomy was assessed in a double-blind trial in 56 subjects of ages ranging from 4-11 years. The raw tonsil bed was sprayed before the childrens' mealtimes and the appraisal of post-operative pain was made on the soreness of the throat as assessed by child, parent and surgeon; also assessed were the degree of referred earache, the ability of the child to swallow without discomfort, and the macroscopic appearance of the healing tonsillar bed. Results showed that the benzydamine spray was more effective than placebo in the control of post-operative pain.
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PMID:A comparative study of benzydamine hydrochloride ("Difflam" pump spray) and placebo as analgesics following tonsillectomy. 361 May 11

Lingual tonsillitis can cause various signs and symptoms including nocturnal or supine cough, constant discomfort in the throat, glossal pain, and otalgia. Most patients with lingual tonsillitis have already had palatine tonsillectomy. A lingual tonsil may be visible only by using a laryngeal mirror. An embedded foreign body can cause recurrent tonsillitis with abscess formation, and life-threatening airway obstruction may result. Aberrant lingual thyroid may be the only functioning thyroid tissue. Cryosurgery and the CO2 laser have made lingual tonsillectomy a safe and simple procedure. An abscess of a lingual tonsil should be drained under general anesthesia, and lingual thyroid should be treated conservatively unless it produces obstructive symptoms.
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PMID:Lingual tonsillitis. 374 99


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