MIAMI — The American government employees in Cuba who suffered mystifying symptoms — dizziness, insomnia, difficulty concentrating — after hearing a strange high-pitched sound all had one thing in common: damage to the part of the inner ear responsible for balance, according to the first doctors to examine them after the episodes.

Two years after Americans posted at the United States Embassy in Havana began experiencing the peculiar phenomenon, doctors at the University of Miami on Wednesday published a scientific paper that confirms what these patients have said all along: Their condition is real, not the result of mass hysteria, a response to intense news media coverage or a stress reaction to being evacuated, as doctors in Cuba had suggested.

“These people were injured,” said Dr. Michael E. Hoffer, the director of the university’s Vestibular and Balance Program and lead author of the study. “We’re not sure how. The injury resulted in ear damage and some trouble thinking.”

To some of the 26 people affected, the episode felt like something out of “Star Trek”: A few minutes of a high-pitched noise, often accompanied by a high-pressure sensation, described as a “force field,” felt in their homes and hotel rooms in Cuba over several months starting in late 2016, changed their lives and, in some cases, ended careers.