Transtympanic facial nerve injury in welders

The risk for ear injury from molten metal or hot sparks produced during welding procedures is small, but the effects can be significant. Burns, tympanic membrane perforations and chronic otorrhoea are the most common results. Rare cases of inner ear injury and facial nerve paralysis have also been reported. Two cases recently encountered at our institution highlight the risk that exists for facial nerve injury. One patient suffered a significant facial nerve injury and deafness, while the other had a transient facial paresis. The injuries occurred when molten metal (slag) and a hot spark fell into the ear canal while welding. Neither subject was using ear protection at the time. These two cases are presented to highlight the rare but significant hazard of transtympanic facial nerve injury that exists during welding procedures. The use of ear protection is strongly advocated during welding operations that place the ear at risk.