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B221 Ultrasound guided greater auricular nerve block for red ear syndrome: a case report
  1. M Mermiri1,
  2. M Bareka2,
  3. M Ntalouka2,
  4. C Rarras1,
  5. A Petsiti1,
  6. A Charalabidou1 and
  7. E Arnaoutoglou2
  1. 1Department of Anesthesiology, Univesrity Hospital of Larissa, Larissa, Greece
  2. 2Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece


Background and Aims Red Ear Syndrome (RES) is a rare disorder characterized by burning pain and redness of one or both ears. Since little to no knowledge exists regarding its etiology, pathophysiology and possible treatment, it remains an unsolved puzzle. We present the case of a patient suffering from RES who was treated in the Chronic Pain Management Clinic of University Hospital of Larissa.

Methods A 28 years old female patient referred to our chronic pain clinic due to disturbing, almost daily automatic flushes of her left ear, lasting from a few minutes to hours, accompanied by redness and burning pain. The initiation of the symptoms was noted after a period of recurrent upper respiratory tract infections, which were further complicated by ear infections. Her medical history revealed chronic headaches, which were treated with gabapentin, propranolol, indomethacin, and amitriptyline.

Results After obtaining informed consent, we applied a greater auricular nerve block under ultrasound guidance. In total, four blocks of the greater auricular nerve were executed, in 6 weeks intervals. Of note, after the completion of the treatment, the prescribing doses of indomethacin and propranolol were reduced, while the everyday life activity of our patient was greatly improved and based on the Pain Outcomes Questionnaire her pain was reduced by 50%.

Conclusions The greater auricular nerve blockade was successful implemented for the management of the pain in a patient suffering from RES. Based on our experience it seems that the aforementioned PNB should be included in our toolbox when dealing with this obscure syndrome.

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