The lightning-damaged ear.

Abstract

We saw four cases of lightning injury to the ear. Substantial ear damage and hearing loss are common in such cases. Temporal bone pathology showed tympanic membrane rupture, middle ear and mastoid effusion of pus and blood, total rupture of the Reissner membrane, degeneration of the stria vascularis and organ of Corti, edema of the intracanalicular portion of the facial nerve, herniation of a portion of the cerebellum into the internal auditory meatus, and a possible microfracture of the otic capsule. Initial treatment should be conservative and reconstructive surgery deferred until tissues have returned to normal.