Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. May 9, 2023; 10(2): 30-35
Published online May 9, 2023. doi: 10.5319/wjo.v10.i2.30
Wet cupping (Al-hijamah) as a strange cause of ear trauma: A case report
Raid M Al-Ani
Raid M Al-Ani, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, Ramadi City 31001, Anbar, Iraq
Author contributions: Al-Ani RM has the responsibility for the design of the study, writing the abstract, core tip, introduction, case presentation, discussion, conclusion, and references according to the journal style, and edited the draft and preparing the final version of the manuscript; Al-Ani RM revised and approved the final version of the manuscript.
Informed consent statement: Informed consent was obtained from the patient for publication of the case with its related images.
Conflict-of-interest statement: The author declares that there is no conflict of interest.
CARE Checklist (2016) statement: The author have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Raid M Al-Ani, MBChB, Academic Editor, Consultant Physician-Scientist, Full Professor, Researcher, Science Editor, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, Al-Andulus, Ramadi City 31001, Anbar, Iraq.
Received: December 31, 2022
Peer-review started: December 31, 2022
First decision: April 13, 2023
Revised: April 14, 2023
Accepted: April 27, 2023
Article in press: April 27, 2023
Published online: May 9, 2023

Cupping therapy is used across the globe since ancient Egypt. It is used as a complementary or alternative to daily clinical practice. Cupping therapy could be dry or wet (Al-hijamah) type. It is considered a relatively safe procedure for a variety of clinical problems like lower backache, shoulder pain, neck pain, headache, and migraine. Application of cupping therapy over body orifices is contraindicated.


A 27-year-old gentleman presented with sudden left-sided hearing loss and tinnitus for 7 d. He gave a history of upper respiratory tract infection 14 d before his complaints. He received Al-hijamah over his left ear 3 d before seeking advice from the Otolaryngology clinic, but without benefit. Physical examination showed a dull-looking left ear drum, hemotympanum in the posterior part of the tympanic cavity, two blood clots over the eardrum, and multiple bleeding points over the external ear canal and tympanic membrane. A pure tone audiogram and tympanogram confirmed the diagnosis of middle ear effusion. Conservative treatment (avoidance of water entry, antibiotics, and local and systemic decongestants) was given for 5 d. The presenting symptoms as well as ear injuries resolved completely two weeks after the follow-up.


We do not recommend using Al-hijamah directly over the ear as a treatment option for hearing loss to avoid unwanted ear trauma as well as there is no benefit from this kind of treatment.

Keywords: Al-hijamah, Ear trauma, Hemotympanum, Secretary otitis media, Cupping therapy, Hearing loss, Case report

Core Tip: Al-hijamah is a useful treatment for a variety of local and systemic diseases. However, Al-hijamah is contraindicated over the body orifices. A 27-year-old gentleman presented with left-sided hearing loss and tinnitus was treated with a Al-hijamah over the left ear. The patient condition persist as well as there were signs of bleeding (fresh blood, clots, and hemotympanum). Secretary otitis media following upper respiratory tract infection was established on clinical background and audiological tests. He was treated successfully by avoidance of water entry, antibiotics, and decongestant. We don’t recommend the usage of Al-hijamah over the ear to treat hearing loss.