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Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation.

Publication ,  Journal Article
Watanabe, K; Tubbs, RS; Satoh, S; Zomorodi, AR; Liedtke, W; Labidi, M; Friedman, AH; Fukushima, T
Published in: World Neurosurg
December 2016

UNLABELLED: Glossopharyngeal, nervus intermedius, and vagus neuralgias can all present with ear pain. However, to our knowledge, there have been no reports of otalgia as the only symptom of vagus neuralgia. The seventh, ninth, and tenth cranial nerves have many interneural connections, and the exact anatomy and pathophysiology of these neuralgias are often not clear. Moreover, symptoms due to involvement of any of these nerves can be difficult to attribute solely to 1 of them. The overlapping sensory innervation of the external auditory canal can lead to misdiagnosis in patients suffering from otalgia. This report presents a case of pure otalgia due to vascular compression of the vagus nerve (VN) and considers the microanatomic differences between glossopharyngeal and nervus intermedius neuralgia via cadaveric dissections. We report 2 cases of external auditory canal pain that continued following microvascular treatment of trigeminal neuralgia. Intraoperatively and at secondary operation, the posterior inferior cerebellar artery was found to be adherent and to penetrate between the fibers of the VN. Following microvascular treatment of the VN, the pain resolved. CONCLUSION: This is the first report of vagus neuralgia presenting solely with ear pain. Surgeons should be aware that primary external auditory canal pain can be due to vagus neuralgia via its auricular branch and that such patients can be misdiagnosed with glossopharyngeal or nervus intermedius neuralgias.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

December 2016

Volume

96

Start / End Page

293 / 301

Location

United States

Related Subject Headings

  • Vagus Nerve
  • Pain
  • Middle Aged
  • Male
  • Humans
  • Female
  • Facial Nerve
  • Earache
  • Ear Canal
  • 3209 Neurosciences
 

Citation

APA
Chicago
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MLA
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Watanabe, K., Tubbs, R. S., Satoh, S., Zomorodi, A. R., Liedtke, W., Labidi, M., … Fukushima, T. (2016). Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation. World Neurosurg, 96, 293–301. https://doi.org/10.1016/j.wneu.2016.08.102
Watanabe, Kentaro, R Shane Tubbs, Shunsuke Satoh, Ali R. Zomorodi, Wolfgang Liedtke, Moujahed Labidi, Allan H. Friedman, and Takanori Fukushima. “Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation.World Neurosurg 96 (December 2016): 293–301. https://doi.org/10.1016/j.wneu.2016.08.102.
Watanabe K, Tubbs RS, Satoh S, Zomorodi AR, Liedtke W, Labidi M, et al. Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation. World Neurosurg. 2016 Dec;96:293–301.
Watanabe, Kentaro, et al. “Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation.World Neurosurg, vol. 96, Dec. 2016, pp. 293–301. Pubmed, doi:10.1016/j.wneu.2016.08.102.
Watanabe K, Tubbs RS, Satoh S, Zomorodi AR, Liedtke W, Labidi M, Friedman AH, Fukushima T. Isolated Deep Ear Canal Pain: Possible Role of Auricular Branch of Vagus Nerve-Case Illustrations with Cadaveric Correlation. World Neurosurg. 2016 Dec;96:293–301.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

December 2016

Volume

96

Start / End Page

293 / 301

Location

United States

Related Subject Headings

  • Vagus Nerve
  • Pain
  • Middle Aged
  • Male
  • Humans
  • Female
  • Facial Nerve
  • Earache
  • Ear Canal
  • 3209 Neurosciences