2022 Volume 115 Issue 2 Pages 113-116
Lightning strikes, though rare, are associated with a mortality rate of 30%; but even when they are not fatal, they can cause lasting damage. The most commonly reported lightning-induced injury of the ear is tympanic membrane perforation. Although this type of injury sometimes resolves spontaneously, in severe cases the perforation persists.
A 41-year-old male patient was admitted to the critical care center at Tokyo Metropolitan Tama Medical Center after being struck by lightning while riding a bicycle in a thunderstorm. He lost consciousness temporarily and had dermal burn on the head, neck, and upper limbs on the right side. He complained of right hearing loss and ear fullness. Clinical examination revealed rupture of the right tympanic membrane, and an audiogram revealed conductive hearing loss.
The dermal burns were conservatively treated by a plastic surgeon, and the patient was discharged after 15 days. Although the audiogram showed slight improvement of his hearing with time, the tympanic membrane perforation persisted unchanged for 10 months after the injury, until a type I tympanoplasty was preformed to close the perforation. The patient’s hearing was completely restored by six months after this surgery.
Injuries from lightning strikes are rare, but otorhinolaryngologists should be aware of the potential for auditory impairment in such cases.
