Auricular nerve block for otitis externa: A case series

Acute otitis externa (OE) is a prevalent infectious condition of the external ear canal, often presenting with painful inflammation and purulent drainage. Sensory innervation of the external ear and canal involves several nerves, including the auriculotemporal, lesser occipital, great auricular, and auricular branch of the vagus nerve. This case series explores the efficacy of the auricular nerve block as a targeted pain management technique in patients presenting with OE in the emergency department (ED).

Three patients with AOE underwent auricular nerve blocks with bupivacaine 0.5 %. All three patients reported immediate pain relief from nerve block. Two out of the three patients were lost to follow up.

The auricular nerve block is safe and involves injection sites distant from major vascular structures, utilizes a small amount of anesthetic, is easy to perform by a landmark-based technique, and does not require the use of ultrasound.

Auricular nerve blocks may provide a safe, efficient, and localized alternative for OE pain relief. Further research, including larger case series or randomized trials, is recommended to establish its efficacy and refine its application.