Red ear syndrome: Perspectives for the otolaryngologist

Red ear syndrome (RES) is an unusual, often unrecognized condition that has rarely been reported in the otolaryngology literature despite the presence of symptoms and associated disorders of relevance to the otolaryngologist. When present, RES may have diagnostic value when uncertainties arise in cases of sinus headache and referred otalgia. Despite the appearance of a distinctive red ear, as well as symptoms and associated disorders relating to otolaryngology, discussion of RES is generally limited to neurology-based publications. A red ear is typically the one constant finding in RES while clinical presentation, rate of occurrence, duration, manner of onset, and response to treatment vary on a case-by-case basis. RES may have value as a diagnostic tool in cases of sinus headache and referred otalgia. In recognizing that RES is commonly associated with migraine and not sinus-related headaches, the presence of RES could help confirm a diagnosis of migraine and remove sinus headache from consideration. Temporomandibular joint (TMJ) disorder and cervical pathology are commonly encountered in both RES and referred otalgia. When identifying the cause of referred otalgia proves problematic, the presence of RES should prompt the clinician to concentrate on either TMJ or cervical pathology as the more likely diagnostic possibilities.