The Lightning-Damaged Ear

Secondary Missile Injury From Lightning Strike

“…While electrothermal phenomena explain the vast majority of injuries observed in lightning strike victims, including cardiac (3), electrothermal (4), and at least some of the neurological injuries observed, a review of the lightning literature shows an interesting injury phenomenon which is difficult to explain with the electrical and/or thermal injury models and which has become the topic of controversy. This phenomenon includes torn and tattered clothing (5), fractures (6), rupture of shoes, traumatic perforation of tympanic membranes (15)(16)(17)(18)(19)(20)(21)(22)(23), lung contusion and haemorrhage and even pneumomediastinum (7,8).…”

Variations in Otological Presentations of Lightning Strike Victims: Clinical Report of 3 Patients

“…[2,3,7] Middle ear and mastoid effusion, degeneration of stria vascularis and organ of Corti, total rupture of Reissner's membrane, microfractures in otic capsule, and edema of facial nerve were also revealed in autopsy studies. [8] Mechanisms of otological injuries caused by lightning strike remain controversial. Cylindrical shock wave transmission from external auditory canal to inner ear, which has enough force to rupture tympanic membrane and to cause ossicular disruption, is considered to be mechanism of otological injuries.…”

“…[3,9] However, there are cases with intact middle and external ear developing sensorineural hearing loss, facial nerve palsy, ossicular disruption, and dizziness that cannot be explained by any of those mechanisms. [6,8,10] Lightning bolt may directly damage inner ear, which has no bony structure in medial part, and may cause temporary occlusion of internal auditory artery. These are alternative theories to explain neural damage with intact middle and external ear.…”

Lightning fatality with blast, flame, heat and current effects: A macroscopic and microscopic view

“…8,9 Side flash or splash occurs as lightning jumps from its primary strike object to a nearby person on its way to ground. 10 Blunt trauma from lightning can occur from two mechanisms; first, the person may be thrown to a considerable distance by the sudden, massive contraction caused by current passing through the body. Second, an explosive or implosive force occurs as the lightning pathway is instantaneously superheated and then rapidly cooled following the passage of the lightning.…”