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Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses

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A Letter to the Editor to this article was published on 16 February 2023

Abstract

Objectives of review

To review the literature for the evidence base for the aetiology and management of referred otalgia, looking particularly at non-malignant, neuralgic, structural and functional issues.

Type of review

Systematic review.

Search strategy

A systematic literature search was undertaken from the databases of EMBASE, CINAHL, MEDLINE®, BNI, and Cochrane Library according to predefined inclusion and exclusion criteria.

Evaluation method

All relevant titles, abstracts and full text articles were reviewed by three authors who resolved any differences by discussion and consultation with senior author.

Results

44 articles were included in our review. The overall quality of evidence was low, with the vast majority of the studies being case-series with three cohort and four randomised-controlled trials included. The prime causes and management strategies were focussed on temporomandibular joint dysfunction (TMJD), Eagle syndrome and neuralgia. Our meta-analyses found no difference on the management strategies for the interventions found.

Conclusions

Referred otalgia is common and treatment should be aimed at the underlying pathology. Potential aetiologies are vast given the extensive sensory innervation of the ear. An understanding of this and a structured approach to patient assessment is important for optimal patient management.

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Author notes

  1. Munira Ally and Ahmed Moinie are joint first authors

Authors and Affiliations

  1. ENT Department, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB, Hertfordshire, UK

    Munira Ally, Ahmad Moinie, George Mochloulis & Ananth Vijendren

  2. Lister Education Centre, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB, UK

    Joan Lomas

  3. Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    Daniele Borsetto & Manohar Bance

  4. University of Cambridge, Cambridge, UK

    Daniele Borsetto & Manohar Bance

  5. Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy

    Paolo Boscolo-Rizzo

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Ally, M., Moinie, A., Lomas, J. et al. Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses. Eur Arch Otorhinolaryngol 280, 47–59 (2023). https://doi.org/10.1007/s00405-022-07638-7

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  • DOI: https://doi.org/10.1007/s00405-022-07638-7

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