SINGAPORE: Other than the overzealous cleaning of the ear canal with a cotton swab, a strong kiss on the ear may also rupture the eardrum, according to research by Sheba Medical Center at Tel Aviv University in Israel.
In the study, blunt trauma accounted for 56 per cent of the 80 patients analysed. Twenty of them were children who had perforated eardrums. The research was published on Oct 28 in The Journal of Emergency Medicine.
Blunt trauma, which can be caused by extreme under-pressure, occurs when the pressure on the outside of the eardrum rapidly drops, said lead study author Dr Doron Sagiv, an ear, nose and throat (ENT) doctor from Tel Aviv University.
One example of extreme under-pressure that can lead to eardrum perforation is a strong kiss on the ear, according to the report.
Blunt trauma can also occur with extreme over-pressure when a large amount of pressure is generated against the ear, said Dr Erich Voigt, an ENT doctor at New York University’s Langone Health, who wasn't involved in the research.
When this happens, the air or water is compressed into the small space inside the ear. This places a huge amount of pressure on one side of the eardrum and empty space on the other side, said Dr Voigt. To equalise the pressure, the eardrum pops and perforates.
Extreme over-pressure can result when someone is hit on the ear by a hand, an airbag, or a large wave in the ocean, said Dr Voigt.
Meanwhile, using cotton swabs make up 40 per cent of the injuries in the study, said Dr Sagiv, who was surprised by the high incidence. Five per cent of these cases require surgery to repair.
"I hope our study will encourage more physicians to recommend their patients to avoid using these swabs for cleaning their ears,” he said.
When the eardrum is punctured, the injury can cause pain, hearing loss and increased susceptibility to infections as germs can travel deeper into the ear, according to the National Library of Medicine (NLM).
Of the 20 injured children in the study, the researchers reported that all had healed on their own. However, four of the 40 injured adults required surgery.
Dr Voigt noted that the study did not include cases of perforated eardrums caused by air pressure changes when flying in an airplane - something he encountered in his practice.
He suspected that the researchers excluded them because the paper focused on physical trauma rather than injury caused by barometric pressure changes.