A 9-year-old with acute follicular tonsillitis complains of bilateral earache. Otoscopy shows normal tympanic membranes bilaterally. The referred pain to the ear is explained by:

• A Shared auriculotemporal nerve innervation of tonsil and pinna
• B Vagus fibres from the tonsil supplying the external auditory canal
• C Greater auricular nerve carrying sensation from both regions
• D Glossopharyngeal fibres supplying the tonsil reaching the middle ear via the tympanic plexus ✓

Explanation

The palatine tonsil receives its sensory supply from the glossopharyngeal nerve. Branches of IX pass through the tympanic plexus on the promontory to supply the middle ear mucosa, so tonsillar inflammation produces referred otalgia despite normal ears. The vagus supplies the external canal and larynx, not the tonsil, and the greater auricular and auriculotemporal nerves have no tonsillar territory, eliminating the other options.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.