BLAST INJURY TO THE EARS: OUR EXPERIENCE IN A CONFLICT RIDDEN AREA
Abstract
Background: The ear is commonly affected in persons who sustain blast injuries as it is one of the most sensitive pressure transducers in humans. Methods: In this study 146 ears of 73 victims of blast injury were evaluated and followed up for 2 years. Results: In our study we encountered 120 tympanic membrane perforations out of 146 ears examined. Out of which 62.5% cases of tympanic membrane perforation healed spontaneously while 37.5% required tympanoplasty and 2.5% had to undergo revision tympanoplasty. Ossiculoplasty was requires in 29.8% cases. 13.0% had mixed hearing loss, none cases of pure SNHL and 1.6% cases developed cholesteatoma. These results were in congruence to the earlier studies. Conclusion: An observation period of at least 3 months is recommended in tympanic membrane perforation due to blast injury and the results of tympanoplasty are also generally good.
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Rawlins JS : Physical and pathophysiological effects of blast. Injury 1977;9: 313 – 20 .
Hill JF : Blast injury with particular reference to recent terrorist bombing incidents . Ann R Coll Surg Engl 1979 ; 61: 4 – 11 .
Cho SI, Gao SS, Xia A, et al. . Mechanisms of hearing loss a
Garth RJ. Blast injury of the auditory system: a review of the mech¬anisms and pathology. J Laryngol Otol 1994;108:925-9.
Garth RJ. Blast injury of the ear: an overview and guide to manage¬ment. Injury 1995;26:363-6.
Akin FW, Murnane OD. Head injury and blast exposure: vestibular consequences.
Otolarayngol Clin North Am (2011) 44(2):323–34. doi:10.1016/j.otc.2011.01.005
Robbins A. Tympanic-membrane perforation as a marker of concussive brain
injury in Iraq. N Engl J Med (2007) 357(8):830–1. doi:10.1056/NEJMc076071
Sayer NA. Traumatic brain injury and its neuropsychiatric sequelae in war
veterans. Annu Rev Med (2012) 63:405–19. doi:10.1146/annurev-med-
-154046
Scherer MR, Schubert MC. Traumatic brain injury and vestibular pathology as
a comorbidity after blast exposure. Phys Ther (2009) 89(9):980–2. doi:10.2522/
ptj.20080353
Scott SG, Belanger HG, Vanderploeg RD, Massengale J, Scholten J.
Mechanism-of-injury approach to evaluating patients with blast-related
polytrauma. J Am Osteopath Assoc (2006) 106(5):265–70.
Van Campen LE, Dennis JM, King SB, Hanlin RC, Velderman AM. One-year
vestibular and balance outcomes of Oklahoma City bombing survivors.
J Am Acad Audiol (1999) 10(9):467–83.
Pogoda TK, Hendricks AM, Iverson KM, Stolzmann KL, Krengel MH,
Baker E, et al. Multisensory impairment reported by veterans with and
without mild traumatic brain injury history. J Rehabil Res Dev (2012)
(7):971–84. doi:10.1682/JRRD.2011.06.0099
Remenschneider AK, Lookabaugh S, Aliphas A, et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol. 2014;35:1825-1834.
Saliba I. Hyaluronic acid fat graft myringoplasty: how we do
it. Clin Otolaryngol. 2008;33:610-614.
Wolf M, Kronenberg J, Ben-Shoshan J, et al. Blast injury of the ear. Mil Med. 1991;156:651-653.
Phillips YY, Zajtchuk JT. Blast injuries of the ear in military operations. Ann Otol Rhinol Laryngol Suppl. 1989;140:3-4.
Pahor AL. The ENT problems following the Birmingham bombings. J Laryngol Otol. 1981;95:399-406.
Kronenberg J, Ben-Shoshan J, Wolf M. Perforated tympanic membrane after blast injury. Am J Otol. 1993;14:92-94.
Kerr AG, Byrne JE.Surgery of violence: IV. Blast injuries of the ear. Br Med J. 1975;1:559-561.
Ruggles RL, Votypka R. Blast injuries of the ear. Laryngoscope. 1973;83:974-976.
Keller M, Sload R, Wilson J, Greene H, Han P, Wise S.Tympanoplasty following Blast Injury.Otolaryngol Head Neck Surg.2017;157(6): 1025-1033.
Sprem N, Branica S, Dawidowsky K. Tympanoplasty after war blast lesions of the eardrum: retrospective study. Croat Med J.2001;42:642-645.
Breeze J, Cooper H, Pearson CR, Henney S, Reid A. Ear injuries sustained by British service personnel subjected to blast trauma. J Laryngol Otol. 2011;125:13-17.
Singh D, Ahluwalia KJ. Blast injuries of the ear. J Laryngol Otol 1968;82:1017-
Sridhara SK, Rivera A, Littlefield PD. Tympanoplasty for blast-induced perforations: the Walter Reed experience. Otolaryngol Head Neck Surg. 2013;148:103-107.
Remenschneider AK, Lookabaugh S, Aliphas A, et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol. 2014;35:1825-1834
Horrocks CL : Blast injuries: biophysics, pathophysiology and management
principles . J R Army Med Corps 2001 ; 147: 28 – 40 .
Darley DS , Kellman RM : Otologic considerations of blast injury . Disaster
Med Public Health Prep 2010 ; 4 (2) : 145 – 52 .
Kerr AG : Blast injury to the ear: a review . Rev Environ Health 1987 ;
: 66 – 79 .
Gapany-Gapanavicius B , Brama I , Chisin R : Early repair of blast ruptures
of the tympanic membrane . J Laryngol Otol 1977 ; 91: 565 – 73 .
Seaman RW, Newell RC. Another etiology of middle ear cholesteatoma.Arch Otolaryngol. 1971;94:440-442
Kronenberg J, Ben-Shoshan J, Modan M, et al. Blast injury and cholesteatoma. Am J Otol. 1988;9:127-130.
Song SA, Sridhara SK, Littlefield PD. Tympanoplasty outcomes for blast-induced perforations from Iraq and Afghanistan: 2007-2012. Otolaryngol Head Neck Surg. 2017;156:353-359.
Ture’gano-Fuentes F , Caba-Doussoux P , Jover-Navalo’n JM , et al : Injury patterns from major urban terrorist bombings in trains: the Madrid experience. World J Surg 2008 ; 32: 1168 – 75 .
Hull JB : Blast: injury patterns and their recording . J Audiov Media Med
; 15: 121 – 7 .
Chandler DW , Edmond CV : Effects of blast overpressure on the ear: case
reports . J Am Acad Audiol 1997 ; 8: 81 – 8 .
Kellerhals B , Hippert F , Pfaltz CR : Treatment of acute acoustic trauma with low molecular weight dextran . Pract Otorhinolaryngol 1971 ; 33: 260 – 4 .
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