Ear pain or otalgia as a diagnostic problem presents commonly to primary health physicians. Otalgia may be primary, arising from the external auditory canal (otitis externa) or the middle ear (otitis media) or secondary. As the sensory innervation of the ear is richly supplied by branches of the trigeminal, facial, glossopharyngeal, vagal nerve as well as upper cervical nerves it is not surprising that many secondary causes of earache including TMJ dysfunction, dental infections and neoplasias may also be responsible for otalgia.