The kiss of deaf: Four-year-old's big smooch left her mom with partial hearing loss

This is a story about a kiss - an expression of love

so potent from a little girl - that it caused her mother not only to lose her

hearing after a buss on the ear, but to be thrust into the pages of medical

history.

Yet it wasn't the sound of the smackaroo that damaged the hearing of

Hicksville homemaker Gail Schwartzman, but a suction force that displaced the

woman's eardrum, paralyzed a tiny trio of bones and left residual sounds in her

head. Schwartzman's case will be the subject of a medical journal report

within the coming weeks, outlining for the first time what the author calls

"the kiss of deaf."

Schwartzman describes the kiss as physically painful but says it has left

a deeper emotional scar on her daughter. Even as she recounted details of the

buss planted two years ago, the child, now 6, broke into tears, apologizing to

her mom. Schwartzman requested that her daughter's name not be published.

"What actually happened, I was out of the house that day," Schwartzman said.

"And when I returned, I went to say a big hello to my daughter. She was 4

years old at the time. She was sitting on the floor watching TV, and she had

really missed me. So I sat on the floor next to her.

"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 said.

"When she was finished, I had no hearing in that ear. The hearing slowly

came back but with screeching noises in my ear," she said, referring to sounds

known medically as tinnitus. Although some of her hearing has returned,

allowing her to hear in muffled tones, the tinnitus has remained.

Loud noises cause tinnitus

Lisa Freeman of the American Tinnitus Foundation said loud noises can induce

tinnitus.

"Typically this is the perception of sound in the ears or head. The sounds

can range from ringing, clicking, swishing or buzzing and can cycle to moments

of highs and lows," Freeman said.

She said tinnitus can be induced by sustained exposure to sounds usually

greater than 85 decibels. The average rock concert hits the ears at 110

decibels and has left countless musicians with tinnitus.

"That was some kiss," Freeman said.

Dr. Anil Lalwani, chairman of physiology and neuroscience at NYU Medical

Center in Manhattan, who was not involved in Schwartzman's case, said he has

never heard of a kiss causing hearing loss.

Many of the cases he has treated, involving extreme sound exposure

followed by hearing loss and tinnitus, increasingly have included soldiers

who've served in Iraq. Thundering explosives have stolen hearing and left

tinnitus as a permanent reminder.

Tinnitus, Lalwani said, is caused by damage to hair cells in the inner

ear's cochlea, a shell-shaped structure that transmits sound signals to the

brain.

Schwartzman shuns attention drawn by the kiss, arguing strongly against

having her picture taken.

"It's not like I won something," she said, referring to a lottery or a

prize for a a major discovery.

Numerous doctors whom Schwartzman consulted immediately after the kiss

were unable to solve the mystery of what precisely went awry. Scans and a

battery of sophisticated tests were conducted. One physician prescribed a

potent hormone. No luck.

Then, last year she read a story in Newsday about a hearing expert at

Hofstra University who spices his lectures by delivering them in rhythm and

rhyme, and thought she would give him a try.

Sherlock Holmes of hearing

Levi Reiter, Hofstra's chairman of audiology, who also has a private

practice in Brooklyn, likens his role in Schwartzman's case to that of Sherlock

Holmes. He posits the kiss created a suction as would a vacuum cleaner or

plunger over a drain.

"It's possible that things will get better as time goes by. Her tinnitus

has gotten better; the other ear is just fine," Reiter said. "It could have

been a lot worse."

In addition to helping Schwartzman cope with her hearing loss, he has

been studying the case over the past year, honing his hypothesis. Reiter

believes the suction of the kiss dramatically disturbed the tiny trio of

interconnected bones - the hammer, anvil and stirrup. He contends the kiss

caused a slight detachment of the stirrup from the muscle and an inflammatory

response. Reiter's report will appear in The Hearing Journal later this summer.

When checking with experts nationwide to determine whether others had

encountered patients deafened by a kiss, he found only one, a retired professor

from the University of Connecticut who knew of a case in the 1950s. A

scientific report was never written.

Reiter said Schwartzman lost her ability to perceive sound in what he

calls the mid-frequencies. Normal conversation, he said, hits the ears at about

50 to 55 decibels. But her loss covers a large range. She cannot use a

telephone on her left ear.

Reiter sees the case as a platform to discuss the etiquette of kissing.

"The moral here is very simple," Reiter said, "try not to hurt the one you

love."

A deafening kiss

A kiss on the ear by a 4-year-old child caused a bizarre chain of physiological

events that damaged her mother's hearing.

The suction caused by the kiss pulled the eardrum outward toward the ear canal,

which in turn pulled her ossicular chain until it detached the stapedial

ligament, causing extreme problems with modulating loud noises

OSSICULAR CHAIN

1 Malleus (Hammer)

2 Incus (Anvil)

3 Stapes (Stirrup)

Immediate consequences from kiss*

n Sudden hearing loss

n Intense tinnitus

n Facial muscle twitching

n Hypersensitivity to loud sounds

*Most symptoms lasted two year after the event

Diagram of ear

Ear canal

Eardrum

Stapedial ligament

Semi-circular canals

Vestibular nerve

Auditory nerve

Cochlea

Eustachian tube