What nerve may cause referred pain to the middle ear?

Referred pain occurs when pain is perceived in a location different from the source of the pain, often due to the overlapping of nerve pathways. The glossopharyngeal nerve is primarily responsible for the sensory innervation of the oropharynx, the posterior third of the tongue, and the middle ear via its tympanic branch. This connection allows it to transmit sensations from the middle ear to the brain.

When conditions like otitis media or other middle ear pathologies occur, irritation of the glossopharyngeal nerve, which conveys sensory information from the middle ear, may lead to referred pain in areas supplied by the same nerve. Thus, a patient may experience discomfort in the throat or tonsillar region alongside ear pain due to the unique anatomical and functional connections of the glossopharyngeal nerve.

The other nerves listed do not have the same direct link to the middle ear. For example, while the facial nerve can contribute to sensations in the ear region, it does not have the same depth of sensory connection to the middle ear as the glossopharyngeal nerve does. The vagus nerve, though contributing to somatic sensations in the throat and neck, does not innervate the middle ear. The trigeminal nerve primarily