carbamezapine (Tegretol) is less successful than in trigeminal neuralgia, and
the roots of the glossopharyngeal nerve may have to be divided by a neuro-
surgeon. A tympanic plexus neuralgia is a similar paroxysmal pain, confined to
the ear, and may be initiated by touching the ear.
Nasal and sinus causes of otalgia are not common, but malignant disease of
the nose and sinuses may cause earache in addition to the local pain.
The larynx must be examined because pain may be referred to the ear in
tuberculous laryngitis and postcricoid cancer.
Cervical causes are mainly neuralgic and may follow a whip-lash injury,
intervertebral joint disease and cervical spondylosis. The pain usually starts in
the occiput and radiates forwards, and it may involve the ear.
SYNDROMES ASSOCIATED WITH THE EAR
Chorda tympani syndrome causes sweating in the submental region after
eating, and is treated by section of the nerve via a tympanotomy approach.
Auriculotetnporal syndrome, or Prey's syndrome, is also associated with
eating and is manifested by sweating and vasodilatation in the cutaneous
distribution of the nerve. It may be found after infection or injury of the
parotid gland, and is due to a disturbance between the sympathetic and
parasympathetic nerves, the tympanic branch of the glossopharyngeal nerve
of the latter system taking part. There is no specific treatment.
Costerfs syndrome is the name sometimes given to disorders of the temporo-
mandibular joint which have been discussed.
Behcefs syndrome is a triad of symptoms, ulceration of the pharynx and
mouth, and of the genitalia, and iritis. It may cause a referred otalgia from the