13.1 Otalgic Neuralgia

• Anatomy:

Medial surface of tympanic membrane, middle ear (ME), mastoid air cells, and ET get sensation/autonomics from the tympanic plexus

Tympanic plexus lies on promontory, anterior to round window niche

Parasympathetic input from glossopharyngeal via Jacobson n (preganglionic secretomotor from inferior salivatory nucleus: supply destined for parotid via lesser superficial petrosal n and thence auriculotemporal nn)

Jacobson n also supplies sensory element to ME and bony ET

Tympanic plexus also gets a parasympathetic input from nervus intermedius (which unites with VII n at geniculate ganglion); VII n (nervus intermedius) gives sensory fibres to posterosuperior aspect of deep external auditory canal (EAC)

Sympathetic (vasoconstrictor, caroticotympanic) fibres to plexus from sympathetic fibres that accompany internal carotid artery (from superior cervical ganglion)