Peritonsillar abscess: A retrospective case series of 1773 patients

tion of throat symptoms and ear pain in a smoker should be foremost in any clinician’s mind. It has been shown that 5% of malignant skull base tumours diagnosed at a tertiary referral neuro-otologic centre presented with referred otalgia. Our rate of approximately 5% of patients with upper aero-digestive malignancy reflects this incidence of mitotic disease in a cohort of patients with secondary otalgia, and all of our patients had associated symptoms or signs. Ear pain as an isolated presenting symptom is unusual in pharyngo-laryngeal cancer but can be the only complaint in the less frequent cases of skull base or temporal bone malignancy. Special attention is crucial in high-risk patients mindful of the younger non-smoking patient with potential HPV-related tumours, particularly where persistent ear pain is associated with any throat symptoms. Investigations should be targeted at any of the 13 Ts dependent on the suspected diagnosis but also including those with idiopathic or unresponding persistent pain. Admittedly, this is a relatively small uncontrolled study, but it does provide guidance for further research into this common complaint.