Background and Objective: OTALGIA is a complaint triggered from either ear disorders or adjacent structures due to common innervations between ear and adjust organs. This study was done to explore the causes of primary OTALGIA.Materials and Methods: This descriptive study was done on 770 patients with OTALGIA in Gorgan, Iran during 2009-10. After clinical examination age, gender, patient complaint and signs were recorded for each patient.Results: 668 patients (86.8%) had primary OTALGIA including 39.9% left, 41.3% right and 18.8% bilaterally. 63.9% were female and 36.1% were males. External otitis was the most common causes of primary OTALGIA with 64.8%. Other causes consist of acute otitis media (14.5%), serumen (14.1%), chronic otitis media (5.8%), foreign body (4%) and trauma (3%), respectively.Conclusion: The most common cause of primary OTALGIA was external otitis.

Introduction:OTALGIA is one of the complaints which may occur at any age. The etiology of the pain may be in the ear, structures around the ear or other head and neck structures. This is caused by the complex nervous connections in the head and neck areas, the ear, the pharynx and the nose. Since understanding the etiologies of referred OTALGIA can help in the assessment and treatment of the disease, this research was conducted to identify the etiologies of referred OTALGIA in patients visiting the ENT Clinic in Gorgan, Iran.Materials and Methods:This prospective research was conducted on patients who visited the ENT Clinic with an earache, but in initial assessments the ear was normal. Patients’ data consisting of sex, age, complaint, the inflicted side, physical findings in the ear, the nose, the throat and head and neck were recorded in a questionnaire. These data were then analyzed with SPSS software.Results:Of 770 patients with OTALGIA, 94 patients (12.2%) had referred OTALGIA. Of these patients 27.7% were men and 72.3% were women. The most common etiology of referred OTALGIA was dental problems (62.8%), and one patient who was being treated for pharyngitis had carcinoma of the base of the tongue. In 47.8% of cases the pain was in the left ear, in 43.4% in the right ear, and in 8.7% it was bilateral.Conclusion:In view of the fact that a significant proportion of the patients who complained of OTALGIA had no pathologies in the ear, thorough physical examination in adjacent structures especially teeth should be performed and malignancies should be considered as a possible etiology of OTALGIA.

BACKGROUND AND OBJECTIVE: OTALGIA is a common compliant of patients at ENT clinic. ‏The main problem in referred OTALGIA may be in head and neck that is referred to ear because of nervous connections. This study was done to determine the varieties of referred OTALGIA and its early diagnosis and treatment. METHODS: This study was performed on patients with complaint of OTALGIA who referred to clinic of ENT. The parameters included age, duration of pain onset, quality of pain, result of physical examination, laboratory findings and some useless investigation by previous medical consultants were registered in questionnaire for 143 patients during 1999. FINDINGS: Among 143 patients, 46% were with referred OTALGIA that 40% were male and 60% were female. The causes of referred OTALGIA were cervical osteoarthritis (15%), unerupted wisdom teeth (21.2%), carious molar teeth (13.6%) and temporomandibular syndrom (13.6%). Six percent of cases suffered from referred OTALGIA due to pharyngeal malignancy. CONCLUSION: The most common cause of referred OTALGIA was unerupted wisdom teeth. About 45% patients with referred OTALGIA had dental problems, therefore attention to dental condition is important in physical examination. Since hypopharynx, nasopharynx and or pharynx cancers are one of the etiological factors for referred OTALGIA, so it is necessary to be more careful in finding the cause of this disease in cases which there is n't any pathological otic finding.

Introduction: Temporomandibular disorders are one of the most common reasons for patients attending dental clinics. Considering the complex anatomy of temporomandibular joint and its proximity to ear, joint disorders have been known as one the major reasons for aural symptoms such as tinnitus, OTALGIA, ear stuffiness feeling and vertigo. The aim of this study was to examine the effectiveness of low level laser therapy (LLLT) in treating tinnitus originating from temporomandibular joint (TMJ) disorders.Materials& Methods: In this randomized clinical trial, patients with symptoms and signs of tinnitus and OTALGIA were examined by an otolaryngologist. Patients with tinnitus and OTALGIA originating from TMJ were included in the study based on diagnoses reached by an oral medicine specialist. The subjects were randomized into the laser (n=16) and control (n=17) groups, using off-mode laser in the control group. In the laser group, the patients were treated with LT-R laser for 4 weeks in 12 sessions. The patients received laser beams in the ear area with a wavelength of 660 nm and a dose of 2.9 J/cm2. In addition, the patients received laser with a dose of 8 J/cm2 in the TMJ area and sensitive muscular regions. The tinnitus and otaliga intensity was evaluated with THI (tinnitus handicap inventory) and VAS (visual analog scale) at 4 time intervals and analyzed with paired t-test and Wilcoxon, Mann-Whitney and Friedman tests.Results: In the laser group, both the THI and VAS scores decreased significantly (p value=0.004). However, in the control group, pain intensity and tinnitus did not show any significant differences between the 4 time intervals (p value=0.641).Conclusion: The results of this study showed the positive effect of low-level laser therapy on tinnitus and OTALGIA. However, long-term effects were not detected.

2Background: OTALGIA is defined as pain localizing in the ear that can be primary or referred. By careful history and physical examination, all causes in this extensive differential diagnosis can be excluded. Given that OTALGIA is one of the most common causes for patients to visit the clinic and has a wide variety of differential diagnosis, the purpose of this study is to investigate the frequency of different etiologies of ear pain in patients referred to referral clinic. Methods: This cross-sectional study was performed on patients presenting with OTALGIA. After entering the study, the patient underwent a thorough examination of the ear, nose, throat, head and neck, teeth and salivary glands by a resident under the supervision of a senior otologist, and based on the findings, relevant para clinical procedures such as x-ray, CT scan or stroboscopy were performed. Data collection was done based on a data log check list. Samples were collected during six months. SPSS software version 20 was used for analyses. Results: The most common causes of OTALGIA were acute otitis media 29%, external otitis 17% and chronic otitis media 15%. Cerumen and referral ear pain were next in line (13. 5%). There was significant relationship between OTALGIA with age groups (The age between 13 and 30 years were the most referred due to OTALGIA). There was no significant relationship between OTALGIA and gender, underlying disease, economic status, smoking and opium use. Conclusion: Given that OTALGIA is a common complaint in patients referred to the clinic, knowing its causes and origin is useful in diagnosing, proper treating it and avoiding unnecessary para clinical procedures and empirical treatment. The most common causes of OTALGIA in this study were acute otitis media, otitis externa and chronic otitis media, respectively. Referral OTALGIA and cerumen impaction were the next causes. Among the age groups, the age between 13 and 30 years were the most referred due to OTALGIA, but there was no significant relationship with any of the variables of gender, economic status and smoking and opium use

Introduction . Tonsillectomy performed by a variety of techniques such as laser bipolor and monopolar electrodissetion and blunt dissection (classic method). Serious and lethal post operative complications secondary to tonsillectomy are related to bleeding and anesthesia. For this reason we have introduced a modified form of electrodissection tonsillectomy using bipolor scissor diathermy to compare the morbidities with classic method. Methods. One hundered patients (2 to 30 years old) candidate for tonsillectomy, were entered in a randomized controlled clinical trial to compare the post tonsillectomy morbidities. Fifty patients were operated with bipolar electrosurgical scissor and fifty patients with classic method. This study was performed in Kashani and Alzahra medical centers of Isfahan University. Patients with a positive history of bleeding tendency and tonsillectomy performed because of tonsillar cancer or uppp. uvulopalato pharyngoplasty) were excluded. Re suits. Bipolar electrosurgical scissor tonsillectomy significantly reduce intraoperative bleeding (3.1±4.5 mL) in comparison to classic method (70±30.61 mL) (P<0.001). No bleeding Dccurs in 24 hours and 10 day after operation in both methods. Mean of pain intensity in both methods, was similar. Mean time of ability for fluid Swallawing after bipolar method was lesser than classic method (3/4±1/47 h VS 4±1/69 h) (P>0.05). Bipolar tonsillectomy siqnificantly reduces the time of operation and anesthesia (7.3±2.76 min VS 11.5±3.29 min) (P<0.001). Only 4 percent of electrodissection qroup and 70 percent of classic group was required to suturing in tonsillar bed (P<0.001). Delayed OTALGIA in electrosurgical grbup was greater than classic group. Discussion. The most common cause of death in tonsillectomy is bleeding and anesthetic complication. We believe the bipolar electrosurgical tonsillectomy result in significantly reduce intraoperative blood loss and time of operation and .lesser need to sutring of tonsillor bed. Thus if we can reduce the post operotive OTALGIA in electrodissection method, this method will be the best technique of tonsillectomy in future.

Background: Temporomandibular disorders are some of the most common reasons for patients to attend dental clinics. According to the complex anatomy of the temporomandibular joint and its proximity to ear, joint disorders have been known as some the major reasons for aural symptoms such as tinnitus, OTALGIA, ear fullness and vertigo. The aim of this study is to examine the effectiveness of low-level laser therapy (LLLT) in treating tinnitus referred from temporomandibular joint (TMJ).Methods: This is a randomized, double-blind placebo-controlled trial. Patients with subjective tinnitus and OTALGIA as their main symptoms were recruited into the study from outpatient clinics in Isfahan private ear, nose and throat clinics. After ENT examination, clinical tests according to each patient’s conditions, patients with tinnitus and OTALGIA due to Temporomandibular joint were studied. The recruited patients were randomized into a laser group (16 subjects) and control group (17 subjects), using the off-mode laser for the second group.In the laser group, patients were treated with LT-R laser (Behsaz Gostar Company, Iran), for 4 weeks and 12 sessions. Patients received laser in the outer ear canal with a wavelength of 660 nm, 40 mW, 0 Hz, for 200 seconds with a special acupuncture probe at a dose of 2.9 J/cm2. Besides, patients received laser with 100 mW, 0 Hz, and 8 J/cm2, without probe, directly and almost perpendicular to the temporomandibular joint and sensitive muscular regions. The same protocol was followed for the control group, but the laser was in off-mode. The tinnitus intensity was evaluated by THI (tinnitus handicap inventory) and VAS (visual analog scale) before therapy commencement, immediately after session 6, after the completion of session 12 of the therapy and also after one month follow up. Parried T-test, Wilcoxon, man-Whitney and Friedman tests were used for data analysis.Results: Amongst 33 patients between 15 to 60, with a mean age of 38.94±11.86 in the laser group was, and 37.12±11.60 in the control group, the study results showed that in laser group, both THI and VAS figures significantly decreased (P=0.004). However, in the control group, pain intensity and tinnitus have not shown any significant difference in the 4 time spans (P=0.641). All patients were compared at the four phases. Although results in all four phases were significant, they have shown that the mean figures of both tests after one-month follow-up have reached scores close to the commencement of treatment.Conclusion: The study has shown that low-level laser therapy has had useful and advantageous effects on patients who suffer from referral tinnitus and OTALGIA. But the long-term effects of laser treatment are suspect.

Introduction: In spite of the fact that acute otitis media is a systemic and symptomatic disease with sever OTALGIA, otitis media with effusion (OME) is an asymptomatic and silent disease. OME is the most common cause of conductive hearing loss in children and has adverse effects on speech development and cognitive skills. Materials and Methods: This cross-sectional study was designed to determine the prevalence of OME in 1001 children, 3-6 years old in different kindergartens of Kerman. The subjects were evaluated by multi-staged randomized sampling. They were examined by otoscopy and pneumatic otoscopy, then suspicious cases were referred to Kerman Shafa University Hospital for tympanometry and acousticreflex evaluation to confirm the diagnosis. The collected data were analyzed by SPSS software. Results: Among 1001 children under study, 57 subjects (5.7%) were diagnosed with OME, more than 50% of which were asymptomatic. Periodic OTALGIA and turning up television volume were the most common symptoms. Conclusion: Regarding the improved knowledge on diagnosis and treatment of OME especially in younger children, hearing problems or cognitive and linguistic skills retardation may be avoided by promoting general information.

BACKGROUND: Tonsillectomy is one of the most common methods in Head and Neck operations and in ENT all over the world. Children are the most affected group. There are different methods of tonsillectomy including: the common method of using sharp instruments or a newer method the electrocautery, the monopolar or the bipolar, method. This study was conducted to compare cold dissection with bipolar electrocautery tonsillectomy.METHODS: In a clinical trial carried on 60 patients between the ages of 6 to 15 at Amir-al momenin Hospital in Rasht, one tonsil underwent the bipolar electrocautery tonsillectomy and the other underwent the cold dissection tonsillectomy. The amount of bleeding, duration of operation, throat pain and referral OTALGIA during hospitalization and after discharge were evaluated.RESULTS: The average amount of bleeding related to electrocautery tonsillectomy was 41.2±2.46 ml and in cold dissection, tonsillectomy was 73.13±3.37ml (P<0.001). The mean time of operation was 9.1±0.39 minutes and 15.11±0.65 respectively (P<0.001). On the second day after operation, 21.67% of the patients had more pain on the cauterized side and 31.67% experience pain on the other side. 46.66 of the patients had equal pain on the two sides.15% of the patients had referral OTALGIA in the cauterized side and 16.67% in the other side. There was no pain in 68.37% of the patients.CONCLUSIONS: The bipolar electrocautery appears to cause less bleeding and postoperative pain and it seems to be less time consuming in compare with the cold dissection tonsillectomy.

Ossifying stylohyoid ligament can be accidentally found in panoramic images. This status is occasionally asymptomatic. However, it is called the Eagle’ s syndrome in the presence of symptoms such as pain in the pharynx, a foreign body sensation, tinnitus, or OTALGIA. The other symptoms may be reported due to the pressure on the carotid artery including migraines, aphasia, or vertigo and syncope, especially in turning head to the suffering side. The presented case was a thirty-nine-year-old man by a thick ossified stylohyoid ligament in both sides, along with five pseudoarticles and a record of the head and neckache, especially in cold weather.