A 60-year-old smoker presents with unilateral serous otitis media and severe referred earache. Biopsy of an ulcerating nasopharyngeal mass confirms squamous cell carcinoma. Pain reaches the middle ear via which nerve running on the promontory?
- A Arnold nerve, auricular branch of vagus
- B Nerve of Wrisberg, intermedius component of facial
- C Jacobson nerve, tympanic branch of glossopharyngeal ✓
- D Auriculotemporal nerve, branch of mandibular division
Correct answer: C. Jacobson nerve, tympanic branch of glossopharyngeal
Explanation
Jacobson nerve, the tympanic branch of the glossopharyngeal nerve, enters the middle ear through the tympanic canaliculus and ramifies over the promontory as the tympanic plexus, carrying general sensation from the middle ear mucosa. Glossopharyngeal afferents also supply the nasopharynx and tonsillar fossa, so tumours there produce referred otalgia. Arnold nerve carries referred pain from the external auditory canal and larynx, not from the middle ear mucosa, killing option A.
Reference: Gray's Anatomy, 42nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.