Facial paralysis ear pain without herpes may be caused by the normal course of facial paralysis, Hunt’s syndrome, facial paralysis combined with otitis externa. 1. Normal course of facial paralysis: Part of the nerve fibers from the facial nerve innervates the sensation of the external auditory canal and the postauricular mastoid area. Damage to this part of the nerve fibers in facial paralysis may produce pain in the postauricular mastoid area. 2. Hunt’s syndrome: caused by herpes virus infection of the geniculate ganglion of the facial nerve, patients may have severe pain in one ear, peripheral facial paralysis, and often herpes in the ear, but patients do not always develop herpes. 3. Facial paralysis combined with otitis externa: otitis externa is an acute limited purulent lesion of the skin of the external auditory canal caused by bacterial invasion and infection due to ear digging injury or bathing leading to the accumulation of water in the external auditory canal and softening of the local epidermis. Facial paralysis combined with otitis externa may present with facial paralysis and ear pain. There are many reasons why facial paralysis patients have pain behind the ear, and it is recommended to consult a doctor in time to clarify the cause of the disease, and under the guidance of the doctor for proper treatment.