Benign Paroxysmal Positional Vertigo (BPPV): This condition is common in the elderly and can cause vertigo and ear discomfort due to the movement of calcium particles in the inner ear. The patient's age and symptoms align with BPPV, making it a likely diagnosis.

Meniere's Disease: A disorder of the inner ear that affects balance and hearing, causing vertigo, ear fullness, and hearing loss. It's more common in older adults and could explain the patient's symptoms.
Labyrinthitis: An inner ear infection that can cause vertigo, ear pain, and hearing loss. The elderly are more susceptible to infections, making this a plausible diagnosis.
Otosclerosis: A condition where abnormal bone growth in the middle ear causes hearing loss and vertigo. It's more common in women and can present in older age.

Stroke or Transient Ischemic Attack (TIA): Although the patient does not have high blood pressure, a stroke or TIA can still occur and present with vertigo and ear symptoms. Missing this diagnosis could be catastrophic.
Acoustic Neuroma: A rare tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and ear pain. While rare, it's essential to consider due to its potential impact on the patient's quality of life.
Temporal Bone Fracture: A fracture in the bone surrounding the inner ear, which can cause vertigo, ear pain, and hearing loss. This diagnosis is critical to consider, especially if the patient has a history of trauma.

Vestibular Migraine: A condition where migraines cause vertigo and ear symptoms. While more common in younger populations, it can still occur in the elderly.
Autoimmune Inner Ear Disease: A rare condition where the immune system attacks the inner ear, causing vertigo, hearing loss, and ear pain.
Superior Semicircular Canal Dehiscence: A rare condition where a hole in the bone above the inner ear causes vertigo and hearing loss. This diagnosis is often overlooked but can be treated surgically.