To Stankovic, chief of the division of otology and neuro-otology, the problem did not sound idiopathic; she suspected that Behforouz had inadvertently fractured

To Stankovic, chief of the division of otology and neuro-otology, the problem did not sound idiopathic; she suspected that Behforouz had inadvertently fractured a tiny delicate bone in her middle ear called the malleus. When she examined the records of Behforouz’s previous hearing tests, Stankovic realized that the results had been misinterpreted. Behforouz didn’t have sensorineural hearing loss — damage to the nerve. Instead, she had conductive hearing loss, a problem with the way sound is transmitted. The difference is important because some forms of conductive hearing loss can be fixed through surgery. Malleus fractures, which prevent sound from being properly delivered to the middle ear, are rare, Stankovic said, and probably underdiagnosed. She said researchers at Mass Eye and Ear have studied 13 patients with the fracture and “every one had the same story”: sudden hearing loss after what doctors call “digital ma­nipu­la­tion.” Moisture “provides the perfect pressure seal,” Stankovic said, and force can result in fractures to the bones in the ear, which are the smallest in the body. Behforouz had an additional risk factor: osteoporosis, the bone-thinning disease. The lesson: keep your fingers out of your ears!