Otalgia associated with migraine

Otol Neurotol. 2011 Feb;32(2):322-5. doi: 10.1097/MAO.0b013e318200a0c4.

Abstract

Objective: To investigate the association of otalgia and migraine.

Study design: Retrospective survey with evaluation of otalgia response to migraine treatment. Only patients with minimum symptom duration of 3 months, who accepted migraine treatment and had a minimum follow-up of 3 months, were included.

Setting: Single neurotology practice.

Subjects: All patients with otalgia in whom other causes of otalgia had been excluded and who were treated with migraine therapies.

Intervention: Standard first-line abortive and prophylactic migraine therapies.

Main outcome measures: Specific clinical data, as well as pretreatment and posttreatment severity scores, were gathered. Response to treatment was assessed by comparing pretreatment and posttreatment symptom scores using paired t test.

Results: A total of 26 patients were included. Ninety-two percent responded to migraine therapy with improved symptom frequency, severity, and duration (p < 0.001). Median duration of symptoms was 5 years. Mean delay to response was 2.3 weeks, and mean follow-up was 20 months. Otalgia was the chief complaint in 77%. Pain was dull in 35%, sharp in 19%, throbbing in 19%, and mixed in 27%. Sixty-five percent demonstrated triggerability of otalgia. A total of 65% had International Headache Society migraine. Patients responded to many classes of migraine preventive and abortive medications.

Conclusion: Otalgia of unclear cause can be related to migraine mechanisms. Our group showed a high prevalence of migraine characteristics, including headache, migraine-associated symptoms, patterns of triggerability, and response to migraine treatment. Clinical criteria for diagnosis of migraine-associated otalgia are suggested for future prospective study.

MeSH terms

  • Adult
  • Aged
  • Audiometry, Pure-Tone
  • Earache / etiology*
  • Female
  • Hearing Loss, Conductive / etiology
  • Hearing Loss, Conductive / pathology
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / complications*
  • Migraine Disorders / drug therapy
  • Neuroma, Acoustic / pathology
  • Pain Measurement
  • Physical Examination
  • Retrospective Studies
  • Sex Factors
  • Temporomandibular Joint Disorders / complications
  • Treatment Outcome