CASE REPORT article
Front. Oral Health
Sec. Oral and Maxillofacial Surgery
Volume 6 - 2025 | doi: 10.3389/froh.2025.1595944
This article is part of the Research TopicOro-facial Pain: Pathophysiology, Molecular Mechanisms, Diagnostic Innovations and Multidisciplinary ManagementView all articles
A Complex Case of Neuropathy and Temporomandibular Disorders Manifesting as Otalgia
Provisionally accepted
- 1School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- 2Leonard M. Miller School of Medicine, University of Miami, Miami, United States
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Patients with temporomandibular disorders (TMD) often reports otological symptoms as their primary complaint. Nervus intermedius neuropathy, a rare condition, is characterized by paroxysms of sharp pain inside the ear. When a patient presents with overlapping symptoms of TMD, nervus intermedius neuropathy in association with psychological comorbidities, and sleep disturbances, it becomes more challenging for the clinician to diagnose and manage them.Therefore, we aimed to report a case of young female presented to the orofacial pain clinic with symptoms of debilitating ear pain, affecting quality of life. Patient responded partially to medications and conservative therapies. Adding psychosocial interventions along with botulinum toxin provided notable relief in refractory pain characteristics. In conclusion, nervus intermedius neuropathy is not commonly encountered in clinical practice but it can co-exist with painful TMD, sleep and psychological problems. In such refractory chronic pain cases injection of botulinum toxin therapy is a critical component for patient management.
Keywords: Temporomandibular disorders, Otalgia, Nervus intermedius neuropathy, Botulinum Toxin, Pain
Received: 18 Mar 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Shrivastava, Soliman and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liang Ye, Leonard M. Miller School of Medicine, University of Miami, Miami, United States
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