The clinical evaluation begins with the characterization of pain, its location, and possible triggering factors. The physical examination should include inspection of the ear and auditory canal to rule out external otitis, foreign bodies, or visible lesions, as well as palpation of the mastoid and periauricular regions to assess for local inammatory signs. The trigger test for intermediate nerve neuralgia should be performed by stimulating the posterior wall of the auditory canal and the periauricu­lar region to check for pain reproduction. The evaluation of cranial nerves is essen­tial, as decits in the facial (VII), vestibulocochlear (VIII), or glossopharyngeal (IX) nerves may indicate associated pathologies such as pontocerebellar angle tumors or multiple neurovascular compressions. The Schirmer test can be used to assess lacrimal dysfunction, while taste evaluation may reveal alterations in taste perception and help localize the lesion.