title: Characteristics of subjects with secondary otalgia.
abstract: OBJECTIVE
  To investigate whether secondary otalgia is associated with cervical spine disorder (CSD), temporomandibular disorders (TMD), or both, and to describe the pain characteristics and the comorbidity of secondary otalgia in subjects with and without CSD and TMD.
  
  
  METHODS
  A mailed questionnaire was sent to a random sample of 2,500 people aged 25 to 65 years. Altogether 1,720 recipients responded. Inclusion criteria were pain inside or around the ear without infection, tumor, or trauma, of 6 or more months duration, and a pain frequency of at least once a month. Altogether 152 respondents fulfilled the criteria, and of these 100 participated in the clinical examinations and interviews.
  
  
  RESULTS
  Based on standardized examinations and interviews, 91 subjects had secondary otalgia and 9 had primary otalgia. Most (85%) of the 91 subjects with secondary otalgia also had signs and symptoms of TMD and/or CSD and were therefore classified into 3 groups: CSD (35%), TMD (20%), or "Combination," ie, signs and symptoms of both TMD and CSD (30%). Subjects without CSD or TMD (15%) reported the same level of intensity and impact of otalgia on daily living and psychological distress as the others but less frequent head and neck pain and fewer sleep-related problems.
  
  
  CONCLUSIONS
  Most of the subjects reporting secondary otalgia also suffered from CSD or TMD or both. Thus, in patients with secondary otalgia, an examination of the cervical spine and the stomatognathic system should be routinely performed.
authors.affiliation: Department of Otorhinolaryngology, Central University Hospital, Turku University, Turku, Finland. seppo.kuttila@otonhammas.fi
authors.forename: Seppo
authors.initials: S
authors.lastname: Kuttila
authors.forename: Marjaana
authors.initials: M
authors.lastname: Kuttila
authors.forename: Yrsa
authors.initials: Y
authors.lastname: Le Bell
authors.forename: Pentti
authors.initials: P
authors.lastname: Alanen
authors.forename: Jouko
authors.initials: J
authors.lastname: Suonpää
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D016009:Chi-Square Distribution; D004433:Earache / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006261:Headache / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology; D011159:Population Surveillance; D020069:Shoulder Pain / Q000453:epidemiology; D013122:Spinal Diseases / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology; D013997:Time Factors