Ear injuries caused by lightning: report of 18 cases

Abstract

The clinical management and long-term outcome in lightning survivors with substantial ear damage treated at the Department of Otorhinolaryngology, University Hospital Split during the 1984-1999 period are reviewed. Results of clinical management and outcomes of lightning ear damage in 18 patients (mean age 35.3 +/- 5 years) were retrospectively analyzed. On admission, all patients complained of severe pain, tinnitus and hearing impairment. Otomicroscopy revealed tympanic membrane rupture in 12 patients. The active therapeutic approach included immediate otomicroscopy, aseptic aspiration toilet, and eversion of perforation edges. In all patients, the ruptures healed well, and restitution of the hearing function was achieved. Follow-up examination performed in 1999 (13.2 +/- 2.9 years later) in 11 patients (mean age 52.3 +/- 6.1 years) revealed an almost identical audiogram as on discharge from the hospital, however, neuropsychological testing revealed numerous sequelae. Tympanic injury caused by lightning should be actively treated. Lightning survivors require additional psychotherapeutic treatment.

National Athletic Trainers' Association Position Statement: Lightning Safety for Athletics and Recreation

“…Other frequently reported results of lightning are superficial burns, ocular and tympanic membrane damage, and psychological and cognitive dysfunction. 43,44,58,59 Superficial burns occur in fewer than 30% of patients and are more often associated with metal on clothing or jewelry that is heated by the contact with lightning. 44 Tympanic membrane ruptures have been reported in many patients and may be associated with the concussive nature of the lightning strike.…”

“…44 Tympanic membrane ruptures have been reported in many patients and may be associated with the concussive nature of the lightning strike. 43,44,58,59 Some survivors are unable to return to their previous level of function. They may become incapable of continuing in their current jobs or educational pursuits and may be permanently disabled.…”

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“…• Rupture of tympanic membranes should be noted (use an otoscope) (Jones et al 1991;Redleaf and McCabe 1993;Gordon et al 1995;Glunic and Roje 2001).…”

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“…[1011] Secretory otitis media, transient dizziness may follow such events. Ocular manifestations may include corneal burns, intravitreal hemorrhage, uveitis, choroido-retinits, and iridocyclitis.…”