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A 55-year-old man with secondary otalgia due to cervical spondylosis. Axial bone algorithm CT shows marked left-sided facet arthropathy (white arrow), which along with uncovertebral hypertrophy (black arrow) results in narrowing of the C II to C III neural foramen (white arrowhead). Impingement of the C III nerve root can lead to otalgia via referred pain along the great auricular or lesser occipital nerves.
