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Introduction

Hair often falls into the EAC after a haircut or may be pushed deep into the EAC in a patient who has hirsute ear canals. While in many instances, no problems result and the hairs migrate out naturally, deep impaction against the tympanic membrane may be associated with numerous distressing symptoms around the ear and can even result in referred pain in the head and neck . We report, for the first time in known literature, a case series of 3 patients who complained of hearing distortion, otalgia and objective tinnitus from migrated hair impacting against the tympanic membrane.

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Case 1

Mr Z, is a 22 year old Chinese male, who presented with left sharp otalgia, distortion of hearing which was poorly quantifiable and tinnitus of one week’s duration. The patient’s symptoms started after visiting the barber a week before presentation. The tinnitus was intermittent, described as ‘scratching’ in nature and precipitated whenever the patient ate.

Otoscopy showed a 3 cm hair lodged deep in external auditory canal, with the free end of the migrated hair impacted against the TM in the anterior recess. Audiometry revealed normal hearing thresholds and tympanograms.

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Case 1

Mr Z, is a 22 year old Chinese male, who presented with left sharp otalgia, distortion of hearing which was poorly quantifiable and tinnitus of one week’s duration. The patient’s symptoms started after visiting the barber a week before presentation. The tinnitus was intermittent, described as ‘scratching’ in nature and precipitated whenever the patient ate.

Otoscopy showed a 3 cm hair lodged deep in external auditory canal, with the free end of the migrated hair impacted against the TM in the anterior recess. Audiometry revealed normal hearing thresholds and tympanograms.

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Case 2

Ms K is a 40 year old Chinese female who complains of left otalgia, blocked hearing and tinnitus of 2 weeks duration. This otalgia was sharp and pricking in nature, while the tinnitus was described as ‘scratching’ in nature. Both otalgia and tinnitus were exacerbated through the use of ‘over the ear’ headphones which was required at work, eating and mouth opening. The baseline hearing was distorted and could not be well qualified by the patient. The introduction of a cotton bud into the ear precipitated severe otalgia and loud tinnitus. The patient had received a haircut 2 weeks ago shortly before onset of symptoms.

Otoscopy revealed a 2.5 cm hair in the external auditory canal, with the tip of the hair in contact with the TM in the anterior recess. Manipulation of lateral free end of the migrated hair replicated the patient’s sensation of severe otalgia and loud tinnitus which had been previously associated with cotton bud use. Audiogram and tympanograms were normal bilaterally. The patient had been referred by the family physician who detected the hair on otoscopy.