Sudden conductive hearing loss occurred following finger manipulation in the external auditory canal. Exploratory tympanotomy revealed a fracture and separation of dumbbell-like constriction at the middle of the long crus of the incus. The constriction presumably formed after atrophy of the long crus by previous acute otitis media. Surgical connection of the lower end of the long crus to the manubrium handle of the malleus by a piece of tragus cartilage resulted in hearing improvement.
Insertion of a finger in the external auditory canal is a habitual gesture, prompted by itching, a sensation of obstruction or foreign body in the ear, or occasionally by personal quirk. Such finger manipulation is, in general, believed to be harmless to hearing because its physical effect on the middle and inner ear is insignificant. There has been, to our knowledge, no report of sudden hearing loss by finger manipulation. We recently saw a patient
TERAYAMA Y, MATSUSHIMA J. Sudden Conductive Hearing Loss Caused by Finger Manipulation in the Ear Canal. Arch Otolaryngol. 1983;109(6):425–426. doi:10.1001/archotol.1983.00800200071022
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