What causes pain at the base behind the ear?

Pain at the base of the ear (i.e., behind the ear) may result from conditions such as otitis media with effusion, acute otitis externa, bullous myringitis, or suppurative otitis media.

1. Otitis Media with Effusion

When otitis media with effusion develops due to bacterial or viral infection, inflammatory responses can stimulate the area behind the ear, causing pain at its base.

2. Acute Otitis Externa

In cases of acute otitis externa, inflammation leads to congestion within the external auditory canal, which may exert pressure on the tympanic membrane and cause pain behind the ear as well as at the tragus.

3. Bullous Myringitis

When viral infection triggers bullous myringitis, blisters may form on the tympanic membrane or adjacent structures. Rupture of these blisters releases exudate that can irritate surrounding tissues, resulting in pain behind the ear and within the ear canal.

4. Suppurative Otitis Media

If acute otitis media is left untreated and becomes chronic or progresses to suppurative otitis media, pain behind the ear may occur. This pain may also radiate to the teeth and the ipsilateral side of the head.