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IHSDiagnosisICD-10
11.4Headache attributed to disorder of ears [H60-H95] G44.844  
Coded elsewhere Headache attributed to acoustic neuroma is coded as 7.4.2 Headache attributed directly to neoplasm . Headache attributed to a lesion, not of the ear, giving rise to referred otalgia is coded according to the site and/or nature of the lesion.

Diagnostic criteria:

  1. Headache accompanied by otalgia and fulfilling criteria C and D
  2. Structural lesion of the ear diagnosed by appropriate investigations
  3. Headache and otalgia develop in close temporal relation to the structural lesion
  4. Headache and otalgia resolve simultaneously with remission or successful treatment of the structural lesion

Comment:

There is no evidence that any pathology of the ear can cause headache without concomitant otalgia. Structural lesions of the pinna, external auditory canal, tympanic membrane or middle ear may give rise to primary otalgia associated with headache.

However, only about 50% of all cases of earache are due to structural lesions of the external or middle ear. Disorders outside this region may lead to referred otalgia as a result of radiation of pain into the ear region. Sensory fibres of the fifth, seventh, ninth and tenth cranial nerves project into the auricle, external auditory canal, tympanic membrane and middle ear. For this reason referred pain from remote structural lesions in any of the anatomical regions to which these nerves project can be felt as referred otalgia. Since these are not disorders of the ear they are coded elsewhere according to the site and/or nature of the lesion(s).

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