Left otalgia. Severe furunculosis causing marked oedema and purulent otorrhoea.

© Bruce Black MD

Left otalgia due to pseudomonal otitis externa. Characteristic green moist debris.

© Bruce Black MD

Haemorrhagic bacterial otitis externa causing extreme pain, blockage and tenderness.

© Bruce Black MD

Acute bacterial otitis media causing severe otalgia due to the tension of purulent debris on the drum from within the

middle ear. © Bruce Black MD

True otalgia. Acute otitis media has been followed by drum perforation and bloody otorrhoea.

© Bruce Black MD

Acute right otalgia. Spiny insect in the EAC. Drown with oily drops and remove by instrumentation.

© Bruce Black MD

Peri-otic causes of otalgia. 1: TMJ, 2: Periotic lymphadenitis, 3: Parotitis/malignancy, 4: Post-aural

lymphadenitis, 5: Local musculoskeletal pain. © Bruce Black MD

Right otalgia. Sqamous cell carcinoma of the parotid.

© Bruce Black MD

Acute right parotitis, with accompanying severe right otalgia.

© Bruce Black MD

Peri-otic otalgia. Swollen and tender tissues secondary to acute parotitis.

© Bruce Black MD

Referred otalgia. Mandibular origins. 1: impacted wisdom teeth, 2: dental caries, 3: apical abscess, 4: mandibular

malignancy. © Bruce Black MD

Severe right dental caries causing chronic otalgia.

© Bruce Black MD

Otalgia. Dental root abscesses are a common cause due to V3 nerve referred pain.

© Bruce Black MD

Pharyngeal causes of referred otalgia. 1,2,3, tonsillitis/quinsy/tonsillectomy. 4: aphthous ulcer. 5,6,7: Carcinoma of palate/tonsil/tongue, 8: palatal trauma. 9:

Eagle syndrome. © Bruce Black MD

Acute tonsillitis, bilateral ear pain.

© Bruce Black MD

Palatal carcinoma.

© Bruce Black MD

Carcinoma of the left tonsil. Grinding intractable Lt otalgia.

© Bruce Black MD

Right quinsy. Severe dysphagia right otalgia and right mandibular tenderness.

© Bruce Black MD

Ludwig’s angina. Severe left otalgia from fulminating floor of mouth cellulitis, potentially fatal.

© Bruce Black MD

Laryngeal causes of otalgia. 1: Acute epiglottitis. 2/3/4: Laryngeal/epiglottic/pyriform fossa carcinoma.

5: Trauma. © Bruce Black MD

Acute epiglottitis. Severe swelling, dysphagia, inspiratory stridor, husky voice and dyspnoea.

© Bruce Black MD

Referred otalgia. Pin in base of tongue and epiglottis. © Bruce Black MD

Ingested nail in pyriform fossa. Sharp referred otalgia. Site clearly identified by finger pointing.

© Bruce Black MD