A kiss—a universal symbol of love and warmth, cherished across generations. From soft baby cheeks to a lover’s embrace, kisses are heartfelt gestures. But what if a kiss could take something precious away? Imagine a kiss so sweet yet so dangerous it could leave someone unable to hear.

Welcome to the world of Cochlear Ear Kiss Injury, or more dramatically termed, the "Kiss of Deaf."

What Is the "Kiss of Deaf"?

It may sound like something out of a mystery novel, but this rare condition is as real as it is unsettling. A sudden, affectionate peck on the ear (external auditory canal) creates a powerful negative pressure or vacuum or suction effect. This force can damage the tympanic membrane (eardrum) and disrupt the delicate balance of pressure in the middle ear.

Here’s what happens:

• The suction pulls the eardrum outward, causing trauma.

• This interferes with the ossicular chain—the three small bones (malleus, incus, and stapes) that amplify sound.

• If the stapes become dislodged, it may lead to a leakage of perilymph, a fluid critical for inner ear function.

• The damage extends to outer hair cells in the cochlea, which are essential for hearing. These cells, unlike in non-mammalian species, cannot regenerate in humans.

The result? Permanent hearing loss, tinnitus, and hyperacusis (painful sensitivity to sound).

Dr. Samuel Choudhury, a family physician, brought this topic to light on Instagram, reaching a wide audience and raising awareness about its significance.

Real Stories That Shocked the Medical World

The first documented case of the Kiss of Deaf emerged in 2008, described by Dr. Levi Reiter, an audiologist and professor.

• The Mother and Child Incident
  A 49-year-old woman experienced hearing loss in her left ear after her 4-year-old child unexpectedly kissed her ear. The kiss ruptured her eardrum, leaving her with sensorineural hearing loss (which means there was damage to the inner ear or auditory nerve, but she could still hear to some extent), but no conductive hearing loss (this is the type of hearing loss caused by problems in the middle ear, like dislocated ear bones). Even though the ligament connecting the stapedius muscle to the stapes was torn, it didn't directly affect her ability to hear. Instead, the torn ligament caused hyperacusis, making loud sounds painfully intense, and symptoms like tinnitus, facial spasms, and hypersensitivity to sound. Despite treatment attempts, her condition remained unchanged a year later.

• The Jazz Producer’s Tale
  A similar case surfaced in 1950 when an 82-year-old jazz producer experienced hearing difficulties after his granddaughter kissed his ear.

• The Valentine’s Day Mishap
  In 2023, a man in China ruptured his eardrum while passionately kissing his girlfriend on Chinese Valentine’s Day. The intense suction left him in pain and unable to hear, requiring two months for partial recovery.

Why Babies and Kids Are More Vulnerable

Children’s ear canals are smaller and more delicate, making them particularly susceptible to injury from even a seemingly harmless peck.

What Are the Symptoms?

Patients with ear kiss injuries often report:

• Sudden hearing loss (especially for high-frequency sounds like “sh” and “ch”).

• Persistent tinnitus (ringing in the ear).

• Hyperacusis (intense sensitivity to loud sounds).

• Balance issues or dizziness in severe cases.

Can It Be Treated?

At present, no established treatment guidelines exist for cochlear ear kiss injuries. However, some interventions have been explored:

• Corticosteroid injections: Intratympanic steroids might help if administered within days of the incident, but their efficacy is not proven.

• Hearing aids: While they can enhance sound perception, they don’t address tinnitus or other symptoms.

Unfortunately, there are no randomized clinical trials to guide treatment due to the rarity of the condition.

Prevention: A Simple Yet Powerful Solution

The good news? This condition is entirely preventable.

• Avoid kissing babies, children, or anyone directly on the ear or near the ear canal.

• Educate others about the risks of this affectionate yet potentially harmful gesture.

A Kiss to Remember—Safely

Love is in the details, and protecting those we care for is the ultimate act of affection. While the "Kiss of Deaf" might be rare, its impact is profound and permanent.

So, next time you feel the urge to kiss someone on the ear, remember: that there are countless ways to express love without risking their ability to hear.

Spread awareness, not silence because love should never come at the cost of losing a precious sense.

Would you share this story and help keep tiny ears safe?

Reference

1. Reiter LA. “The Kiss of Deaf”: A case study. The Hearing Journal. 2008 Aug 1;61(8):32-4.

2. Goyal L, Ajmera K, Kaasam S, Koppula K. Tinnitus and Mild Hearing Loss From a Kiss. Cureus. 2022 May;14(5).

3. Dr Sanu P Moideen (2017). Cochlear ear kiss injury - kissing a baby can make them go deaf - ENT. [online] Dr Sanu P Moideen. Available at: https://drsanu.com/blog/cochlear-ear-kiss-injury/ [Accessed 7 Dec. 2024].

4. Hearinglosshelp.com. (2008). ‘Kiss of Deaf’ or ‘Reiter’s Ear Kiss Syndrome’ (REKS). [online] Available at: https://hearinglosshelp.com/blog/kiss-of-deaf-or-reiters-ear-kiss-syndrome-reks/ [Accessed 7 Dec. 2024].

By Josna Lewis

_MSM