AB187. SOH24AB_082. Tweenager referred otalgia

Background: Musculoskeletal pain has been reported as causing two-thirds of referred otalgia in adults. Secondary ear pain in children is recognised but few authors have addressed this condition in the medical literature. The aim of this study was to review a series of paediatric patients aged between the age of 8 and 12 (tweenagers) diagnosed with referred otalgia by a tertiary referral specialist otologist. Methods: A retrospective chart review of tweenagers diagnosed with referred otalgia at a specialist clinic was performed. Patient demographics including age, sex, past history of ear complaints and presumptive primary care referring diagnosis were recorded. The presenting symptoms and signs on examination, audiometry and tympanometry results, probable causative factors, treatment measures and outcomes were tabulated and assessed. Results: Thirty-five cases were identified with clinical data available to satisfy the criteria for inclusion in the study. All had referral diagnoses of recurrent acute otitis media. One patient had a dental cause while all of the rest were felt to be due to posture-related neck pain mostly from over-use of hand-held devices or seating habits while watching television. Conclusions: The vast majority of tweenager secondary otalgia is due to sternomastoid myositis. Secondary ear pain in these is often confused with recurrent acute otitis media. Management can be successful with oral analgesics as required, parental control with limited use of devices, local treatment but as prescription anti-inflammatory topical ointments are not licensed for children of this age, massage or physiotherapy with postural education are recommended.