A 3-year-old girl ruptured her eardrum when she inserted a pencil into her external ear canal. She was urgently admitted to the emergency department. Physical examination revealed pain in her ear and a few drops of blood in the external auditory meatus. There was the concern that there might possibly have been an injury to the nerve that principally innervates the external surface of the tympanic membrane. Which of the following tests is most likely to be performed during physical examination to check for injury to this nerve?
The external surface of the tympanic membrane is innervated primarily by the auriculotemporal nerve, a branch of the mandibular division of the trigeminal nerve. Damage to this nerve would additionally result in painful movements of the TMJ because this joint receives innervation from the same nerve. Taste in the anterior two thirds of the tongue is supplied by the facial nerve and would be unaffected in this injury. The sensory innervation of the nasal cavity is supplied by the ophthalmic and maxillary divisions of the trigeminal nerve and would be unaffected by injury to the tympanic membrane. Sensory innervation to the larynx is provided by the vagus nerve, whereas the pharynx receives sensory fibers from the glossopharyngeal and vagus nerves. The palate is supplied by the maxillary divisions of the trigeminal nerve and would be unaffected by this injury.
Check the taste in the anterior two thirds of the tongue.
Check the sensation to the pharynx and palate.
Check if there is paraesthesia at the TMJ.
Check for sensation in the larynx.
Head & Neck