Immersion with retrograde effusion in the middle ear

Introduction Near drowning and immersion accidents also occurred during the Ahr flood 2021. Case A 79-year-old male patient presented to our emergency department with a condition after several hours in a flooded living room. Multiple immersions and near drownings occurred. The living room was flooded with water, mud, oil and feces. The patient was seen by an ENT-specialist for the first time about 36 hours later. Examination revealed the left middle ear filled with dark liquid with intact tympanic membrane. Slight conductive component with Weber to the right and Rinne only slightly positive. One week later with decongestive therapy and valsalva training, the tympanic membrane findings showed regression and no conductive component in audiometry. In addition, the patient received aspiration pneumonia prophylaxis with piperacillin and tazobactam in case of immersion and questionable contamination of contaminated water. Pneumonia or otitis media did not occur.

Conclusion  During immersion and near drowning, retrograde pushing of with oil, mud and feces polluted water in the middle ear probably occurred. Near drowning accidents are rare and in this case the retrograde penetration into the middle ear could be seen well through the contaminated water.

Publication History

Article published online:
12 May 2023