Shunt Nephritis or Shunt Failure: Given the recent VP shunt removal for hydrocephalus, the most likely cause of the symptoms could be related to the shunt procedure itself. Shunt nephritis or failure could lead to increased intracranial pressure, causing headaches and potentially referred pain to the ear.

Middle Ear Effusion: Elevated intracranial pressure can cause middle ear effusion due to Eustachian tube dysfunction, leading to ear pain.
Tension Pneumoccephalus: After a shunt removal, there's a risk of developing a tension pneumocephalus, especially if there was a dural tear during the procedure. This could cause increased intracranial pressure and referred ear pain.
Meningitis: Post-surgical meningitis is a possibility after a shunt removal, which could explain the elevated intracranial pressure and ear pain.

Cerebral Venous Thrombosis: Although less common, cerebral venous thrombosis could occur in the setting of elevated intracranial pressure and recent surgery, potentially causing severe and fatal outcomes if not promptly diagnosed and treated.
Subarachnoid Hemorrhage: A hemorrhage could occur post-shunt removal, leading to increased intracranial pressure and potentially life-threatening complications.
Brain Abscess: A brain abscess is a serious complication that could arise post-surgically, especially in the context of a shunt infection, and would require immediate attention.

Chiari Malformation: If not previously diagnosed, a Chiari malformation could become symptomatic in the setting of altered intracranial pressure dynamics post-shunt removal, potentially causing ear pain among other symptoms.
Labyrinthine Hydrops (Meniere's Disease): Although less directly related to the recent surgical history, Meniere's disease could cause ear pain and might be considered if other diagnoses are ruled out, especially if there are additional symptoms like vertigo and hearing loss.