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Table 1: Sensory innervation of the ear and potential referred pain origin sites
Nerve Primary Ear Sensory Innervation Origin Site of Referred Pain
CN II and CN III Inferomedial and lateral pinna Skin overlying angle of mandible
Pre- and postauricular skin Lateral neck
Lobule Muscles of neck
Upper cervical facet joints and nerve roots
Atlantoaxial joint
CN V Anterosuperior pinna Gingival and buccal mucosa of oral cavity
External auditory canal Palate
Tympanic membrane Floor of the mouth
Anterior two-thirds of the tongue (sensory nerves)
Mandibular teeth
TMJ
Mandible
Nasal mucosa (sensory nerves)
Paranasal sinus mucosa (sensory nerves)
Parotid gland
CN VII Conchal bowl Nasal mucosa (parasympathetic nerves)
External auditory canal Sphenoid and ethmoid sinuses (parasympathetic nerves)
Tympanic membrane Anterior two-thirds of the tongue (taste fibers)
CN IX Tympanic membrane Stylopharyngeus muscle
Posterior third of the tongue
Palatine tonsil
Carotid body
Pharyngeal mucosa
Parapharyngeal space
Retropharyngeal space
CN X Concha Oropharynx (vallecula and constrictor muscles)
Postauricular skin Larynx
Posterior external auditory canal Hypopharynx (pyriform sinus)
Tympanic membrane Visceral space (thyroid, esophagus, and trachea)