Referred earache; an important symptom of head-and-neck cancers

Otalgia is a common symptom in general practice and represents the sensation of pain in the ear. In four patients, three women aged 63, 57 and 37 years, and a man aged 64 years, ear pain was found to be caused by laryngeal carcinoma (two patients), oropharyngeal carcinoma and nasopharyngeal carcinoma (in a Turkish patient). Referred otalgia is an earache that is caused by a nonotologic source. In many cases it is difficult to identify the underlaying disease of referred otalgia. It may be the first symptom of a head-and-neck carcinoma. In case of otalgia with normal otologic findings, the differential diagnostic process must be specifically directed to the common sensory innervation of the ear and the head-and-neck structures. By carefully taking the patient's history with special attention to epidemiological factors such as smoking and drinking habits, racial traits, a positive family history of head-and-neck neoplasms and accompanying complaints and by performing repeated ENT examination including advanced imaging techniques, long delay in diagnosing head-and-neck cancer can be prevented.