Hicksville, NY, homemaker Gail Schwartzman had been away for the day and when she returned home her daughter gave her a huge kiss on her left ear. Newsday reports it was the suction from her daughter’s kiss that managed to displace her eardrum as well as paralyze a trio of bones in her ear and left her with tinnitus.

“She grabbed me and gave me a hug and a really big kiss on the left ear. And while she was doing it, it felt like she was sucking the air out of my head. I couldn’t push her away because I had this terrible sensation in my head,” Schwartzman told Newsday. “When she was finished, I had no hearing in that ear. The hearing slowly came back but with screeching noises in my ear.”

Schwartzman’s story was widely reported in national media outlets in June 2008.

According to Levi A. Reiter, PhD, professor and audiology program head at Hofstra University (pictured at right), who is set to publish a report on Schwartzman’s situation this summer, Schwartzman’s daughter kissed her aperture of the left ear, resulting in immediate pain, screeching tinnitus, facial spasms, and total hearing loss on her left side.



“Hours later, most of her hearing returned, leaving her with a 35 dB HL sensorineural hearing loss in the lower frequencies: 250, 500, and 1,000 Hz,” Reiter says. “In addition, she was left with screeching tinnitus, hyperacusis, dysacusis
 (distorted hearing), and facial twitching.”

Reiter says that six months before the kiss, Schwartzman had her hearing tested after a cerumen cleaning and it was completely WNL bilaterally. Prior to seeing Reiter, she had seen ENTs, and had audiological evaluations — including ABR and OAE tests — but was given no diagnostic conclusion.
 She was referred to Reiter, who conducted a thorough study including an ABLB to document hyperacusis, and a complete acoustic reflex battery that included contralateral and ipsilateral reflexes. That revealed a paralyzed acoustic reflex on the left side, Reiter says. After facial nerve testing, a fully functional seventh nerve was revealed, suggesting a detached stapedial ligament.

“Therefore the way I understand it, the suction from the kiss pulled the TM laterally, which ultimately pulled the stapes forcefully away from the oval window. This damaged the stapedial muscle or tendon and paralyzed the acoustic reflex — although the ossicular chain was left completely intact (there was no conductive component),” Reiter says. “The abrupt pulling of the stapes out of the oval window caused a tsunami of sorts in the fluids of the cochlea, damaging some of the contents therein [eg, outer hair cells].”

Reiter says the absence of an acoustic reflex unilaterally results in an inability to modulate loudness, which contributed to her documented hyperacusis.

Since Schwartzman’s story was first released, Reiter has found several new cases of “Reiter’s Ear Kiss Syndrome” (REKS), as some have named this disorder.

“If any audiologist or ENT comes across any suction-related cases I would sincerely appreciate hearing from them,” Reiter says. “If verified, their data will be included in an ongoing epidemiological study.”

Reiter can be contacted at ears@drreiter.net.

SOURCES: Newsday; UPI; Dr. Levi Reiter