Otological trauma resulting from the Soho Nail Bomb in London, April 1999

We report the otological effects of the April 1999 Soho Nail Bomb on 17 patients. Twenty-one (62%) tympanic membranes were perforated (pars tensa only); 78% closed spontaneously within 6 months. The mean size of the perforation in the tympanic membrane nearer to the blast was significantly larger than the opposite side [33% +/- 8.3 (mean +/- SD) and 13% +/- 4.1 respectively; P = 0.02]. All patients reported hearing losses that were mixed conductive and sensorineural but mainly high-frequency sensorineural (4, 6 and 8 kHz, pure tone average 42.3 dB +/- 20.5). The sensorineural hearing loss correlated inversely with the distance from the explosion but not with the size of perforation. There was no significant difference in the hearing loss between the ear facing the blast and the opposite ear. Fifteen patients (88%) had temporary tinnitus. No patient complained of any vestibular symptoms. The otological effects of a nail bomb in an enclosed space have not been previously reported. Furthermore, an inverse correlation between hearing loss and distance from the explosion and a significant difference in perforation size facing the blast, compared with the opposite side, are also presented for the first time. The high spontaneous closure rate of perforations and minimal ongoing disability from sensorineural losses favour conservative management in most cases.

A novel approach to the removal of superglue from the ear

The ability of superglue (a cyanoacrylate adhesive) to bond strongly and quickly to skin presents considerable problems when it is inserted into the ear. A case of a patient who inadvertently self-administered Bostik superglue into her left external auditory meatus is reported. The superglue was removed successfully, in the form of a cast, with warm three per cent hydrogen peroxide without damaging the meatus or the typanic membrane. The use of hydrogen peroxide to remove superglue from the ear has not been described previously.