Study Looks into Ear-Related Symptoms Experienced by American Diplomates in Cuba

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It’s vexing for people all over the world that people can be harmed and not know why,” said Michael E. Hoffer, MD, professor of otolaryngology and neurological surgery at the University of Miami Miller School of Medicine in Florida.

Speaking at a press conference held on December 12 at the University of Miami, Dr. Hoffer and coinvestigators shared with the press for the first time the results of a study they recently published on the presenting acute symptoms of the 25 American diplomates and family members who reported ear-related and neurological symptoms following exposure to an as yet unknown source while serving in their embassy roles in Havana starting in 2016 (Laryngoscope Inv Otol. Published December 12, 2018. doi: 10.1002/lio2.231).

The study represents the first step in understanding what remains a mysterious, and in Dr. Hoffer’s word “vexing,” event. Dr. Hoffer highlighted the particular importance of the study as the first of its kind to evaluate the patients in the acute phase of their injury, unaffected by variables that can alter people’s symptoms, such as longer duration of time from injury, treatments for symptoms, worker’s compensation issues, and media coverage. “This is the first and only report of the individuals seen acutely, shortly after the injury,” he said. “It’s the only study that is going to come out as the first naïve report of this condition.”

(A study published in JAMA documents evidence of neurological manifestations of these patients months after the injury, and therefore provides different information than that gathered by Dr. Hoffer and colleagues who report on the acute injuries [JAMA. 2018;319:1125–1133]).

Cause Vague, Symptoms Specific

Dr. Hoffer emphasized that the study and its results focus on the presenting symptoms of the individuals he and his colleagues saw at the University of Miami Miller School of Medicine. Questions of cause were outside the scope of the study.

In the study, Dr. Hoffer and colleagues retrospectively report on the subjective and objective symptoms of 25 individuals who reported symptoms after experiencing a localized sensation of noise/pressure while in Havana beginning in 2016 and continuing into 2017, as well as 10 individuals (roommates of those with symptoms) without symptoms. Most of the symptomatic individuals reported intense ear pain and tinnitus immediately following the exposure. The most common complaints described by the symptomatic individuals were dizziness and disorientation, with some also reporting concerns about hearing loss.

The 35 individuals were sent to Dr. Hoffer and his colleagues for examination shortly after experiencing the noise or pressure and underwent a comprehensive history and physical examination.