Case Report

Vol 1 No I Srinakharinwirot Medical Journal

Abstract Damage of the Ear caused by Thunderbolt

Chirat Neruntarat M.D. *
Lightning - induced injuries are fairly common, but relatively few cases of lightning -
induced damage to the ear have previously been reported. Patients struck by lightning can
present with a wide variety of unusual otologic problems including bums to the exte~nal
auditory canal, tympanic membrane rupture, middle ear injury and sensorineural hearing
loss. Lesions are usually treated according the patient's symptoms. Surgical treatment is

(SMJ 1994 : 1 : 29-34)

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Deprutment of Otolaryngology, Faculty of Medic~ne.Srinakarintrawirot University.
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 Case Report
Srinakharinrvirot Medical journal

PURE TONE AUDIOGRAM

I S 0 : 64, ANSI : 6 9 ASA : 5 1
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KEY

AUDIOLOGIST

125 250 500 750 1000 1500 2000 3000 4000 6000 8000

F U E Q U E N C Y IN HZ ( C P S )

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32
 Case Report
Vol I No I Srinakharinwirot Medical Journal

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ari~~~oioi3noin~oln~l&6~ndia.u"i~Au 1. Browne BJ, Gaasch WR. Electrical injuries and
irii'ay~:q oioliin"aoinnosaria~4~8o'~~~" lightning. Emerg Med Clin North Am 1992 ; 10 - 2
A
1. Electrical energy %9~1tdl$l?dI~1i8q~ : 222 - 9.
2. Blast effect (pressure) 6 ~ 6 6 8 3 ~ 0 ~ ~ 1 : ~
2. Bergstrom LAV, Neblett LM, Sando I, Hemeni,,~ijj,
l u ~ d i h s r i u ~ l l i & ~ e i i s ~ ~ mri:wui~
d:ll~ WG, Harrison GD. The lightning - damaged -a,
v v d
lw:plin nkoinlndulia:~m1niuip11~Ka~~nio9I& Arch Otolaryngol 1974 ; 100 (2) : 117 - 21
3. Todd DH, Meyers A. An ~lnusualotolaryngologic Andrew CJ, Darveniza M. Telephone - mediated
manifestation of lightning strike. Otslaryngol lightning injury : An Australian survey. J Trauina
Head 8r Neck Surg 1994 ; 110 ; 126 - 30. 1986 ; 29 (5) : 665 - 71.
4. @;sig SR..When lightning strikes : Pathophysiology Jones DT, Ogren FP, Roh I,H, Moore GF.
and treatment of lightning injuries. Postgrad Med Lightning and its effects on the auditory system.
1986 ; 79 : 109 - 24. Laryngoscope 1991 ; 101 : 830 - 4.
5. Silverman NM. Unilateral deafness as a sequel to Kouwenhoven WB : Effects of electric~ty on the
nun-fatal lightning trauma. J Indiana State Med human body. Elec Eng 1949 ; 68 : 199 - 200.
A s s ~ o c1936 ; 29 : 530 - 1. Weiss KS. Otologic lightning bolts, Am J Otol
6. Wcst GB. Lightning as a cause of hearing loss. 1980 ; 1 : 334 - 7.
Md State Med J 1955 ; 4 : 35 - 7. Ducall AJ, Rhodes VT. Ultrastructure of the organ of
4. Youngs R, Deck J, Kwok P, Hawke M. Severe Corti following intermixing of cochlear fluids. Ann
sensorineural hearing loss caused by lightning. Otol Rhino1 Laryngol 1967 ; 76 : 688 - 708.
Arch Btnlaryngol 1988 ; 114 : 1184 - 7. Strasser EJ, Davis RM, Menchley MJ, Lightning
8. Cwinn AA, Cantrill SV. Lightning injuries. J Emerg injuries. J Trauma 1977 ; 17 : 315 - 9.
Med 1985 ; 2 : 379 - 88. Ehsan M, Waxman J, Finley JM. Delayed gangrene
9. Gman MA. Lightning. New York. McGraw - Hill, after lightning strike. Am Fam Physician 1981 ;
1969 : 192 - 9. 2 4 : 117 - 9.
10. Wright JW, Silk KL. Acoustic and vestibular Silbergleit AK, Trenkner S W . Dysphagia
de,5::3chs in lighting survivors. Laryngoscope 1974 ; 84 following lightning strike. Dysphagia 1988 ; 2 :
(8) : 1378 - 87. 228 - 9.
11. Poulsen P, Knudstrup P. Lightning causing inner
ear damage and intracranial hematoma. J
Laryngol Otol 1986 ; 100 : 1067 - 70.

Carcinoma en cuirasse : A markedly indurated carcinoma, involving a

br.oad expanse of skin and subcutaneous breast tissue that is covered by
papules and nodules evolving into morphea - like plaques
Histopathology : Exuberant desmoplasia and few tumor cells, the cuirasse
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with carcinoma of the stomach, prostate, lung, uterus and pancreas. Cuirasse,
Breast plates used in suits of armor during the middle ages.