What nerve may cause referred pain to the middle ear?

Referred pain to the middle ear is predominantly associated with the glossopharyngeal nerve. This nerve, which is the ninth cranial nerve, has sensory functions that include innervation to the oropharynx, posterior one-third of the tongue, and the auditory tube, all of which are closely related anatomically to the middle ear. Stimulation or irritation of the glossopharyngeal nerve, often as a result of throat infections or other pathologies, can lead to sensations of pain that may be felt in the middle ear region due to the complex neural pathways involved in sensory transmission.

The anatomical connections between the glossopharyngeal nerve and the middle ear explain why it effectively mediates such referred pain. Understanding these connections can aid clinicians in diagnosing the source of pain when patients present with otalgia without clear ear pathology.