Noise-Induced Hearing Loss (NIHL): This condition is directly related to exposure to loud noises, which can cause damage to the hair cells in the inner ear, leading to ear pain and hearing loss. The direct correlation between loud noise exposure and the onset of ear pain makes NIHL a highly plausible diagnosis.

Eustachian Tube Dysfunction: Loud noises can sometimes exacerbate or trigger Eustachian tube issues, leading to ear pain due to pressure imbalance in the middle ear. This condition is relatively common and can be associated with various triggers, including noise.
Middle Ear Infection: Although not directly caused by loud noises, an existing middle ear infection could be irritated by loud sounds, leading to increased ear pain. Middle ear infections are common and can cause significant discomfort.
Otosclerosis: This is a condition where abnormal bone growth in the middle ear causes hearing loss and can lead to ear pain, especially with loud noises. While not as directly related to loud noises as NIHL, otosclerosis can be exacerbated by noise.

Perforated Eardrum (Tympanic Membrane Perforation): A perforated eardrum can be extremely painful and, if caused by a loud noise (like an explosion), could lead to severe complications if not promptly treated. Although less common, missing this diagnosis could lead to significant morbidity.
Acoustic Neuroma: While rare, an acoustic neuroma (a benign tumor on the nerve connecting the inner ear to the brain) could potentially cause ear pain that worsens with loud noises. Given the potential for serious complications, including hearing loss and neurological issues, this diagnosis should not be missed.

Patulous Eustachian Tube: This rare condition involves the Eustachian tube staying open, which can lead to a variety of symptoms, including ear pain triggered by loud noises. It's less common but should be considered in the differential diagnosis for comprehensive evaluation.
Superior Semicircular Canal Dehiscence: A rare condition where there's an abnormal opening in the bone overlying the superior semicircular canal, which can cause a variety of auditory and vestibular symptoms, including ear pain with loud noises. Given its rarity and potential for significant impact on quality of life, it's essential to keep this condition in mind, even if it's less likely.