B221 Ultrasound guided greater auricular nerve block for red ear syndrome: a case report

• Published in: Regional anesthesia and pain medicine Vol. 47; no. Suppl 1; p. A190
• Main Authors: Mermiri, M, Bareka, M, Ntalouka, M, Rarras, C, Petsiti, A, Charalabidou, A, Arnaoutoglou, E
• Format: Journal Article
• Language: English
• Published: Secaucus BMJ Publishing Group Ltd 01.06.2022; BMJ Publishing Group LTD
• Subjects: Case report; Case reports; Pain; Regional anesthesia; Ultrasonic imaging
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2022-ESRA.295

Background and AimsRed 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.MethodsA 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.ResultsAfter 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%.ConclusionsThe 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.