Blast injury of the auditory system: a review of the mechanisms and pathology

Garth, R. J. N.

doi:10.1017/s0022215100128555

Cited by 42 publications

(52 citation statements)

References 20 publications

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“…Dizziness is rarely seen [1,2,6,9,10,11,14]. While dizziness was reported in only 2 of the 110 cases described by Pahor [5] and in 2 of the 20 cases described by Bruins and Cawood [9], it was a common complaint in the cases who were exposed to explosions in closed areas reported by Kerr and Byrne [6].…”

Section: Discussionmentioning

confidence: 97%

“…The pressure increases in the middle ear cavity cause movement of air through the mastoid system and the eustachian tube to the nasopharynx. Thus, people who have a wide mastoid system and an open eustachian tube have a greater risk of perforation of the tympanic membrane, due to the decreased protective role of air as a cushion [10]. While Ito et al [20] in their series of 25 cases found the mean total volume of 41 temporal bone air cells to be 4.05 B 1.59 ml, Isono et al [21] reported that it was 6 ml in 43 normal temporal bones.…”

Section: Discussionmentioning

confidence: 99%

“…The duration of increase and decrease of pressures in the ear that cause trauma, the position of the ear, shape and size of the auricle, the length of the external ear canal, the presence of foreign objects in the external ear canal, the structure of tympanic membrane and ossicles, the degree of aeration of the temporal bone, and the functional status of the eustachian tube play important roles in the development of the traumatic pathologies of the ear [9,10,12,14]. When the blast trauma is concerned, the dis- Aktaş/Kutlu tance to the explosion site, whether open or closed explosion site, and environmental factors that change or block the direction of blast waves due to changes of air mass have an importance.…”

Section: Discussionmentioning

confidence: 99%

“…Air pressure levels of 5 PSI (pounds/ square inch) cause traumatic perforations in the tympanic membrane. The rate of perforation is 50% at levels of more than 15 PSI and 83%, if the level is between 30 and 50 PSI (244-422 kPa), and in these cases perforations are usually bilateral and the mortality rate increases considerably [9][10][11][12][14][15][16][17][18]. Besides the intensity of pressure, the duration of the exposure is also important.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship between Traumatic Tympanic Membrane Perforations and Pneumatization of the Mastoid

Aktaş¹,

Kutlu

2000

ORL

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We evaluated the possible relationship between tympanic membrane perforations resulting from blast trauma or slap and pneumatization of the mastoid cells. A total of 25 male patients with tympanic membrane perforations resulting from blast injury (n = 7), slap (n = 17), and football hit (n = 1) and 20 healthy male volunteers without any ear problem had temporal bone computed tomographic scans in the axial plane, parallel to the infraorbitomeatal line, with 2 mm slice thickness and 2-mm intervals using bone algorithm with a ProSpeed Spiral tomography machine. The area of air cells in each slice was measured using trace and area measurement functions of the tomography machine, and by multiplying the resulting area by slice thickness, the volume of each slice was calculated. For each ear, the total of volumes of air cells was calculated by adding the volumes of each slice containing air cells. The calculated volumes of mastoid cells were evaluated by comparing microscopic findings. Both patient and control groups consisted of males, and their ages ranged from 17 to 32 (mean 24.5) years. Microscopic examinations revealed that perforations were frequently located in the lower quadrants and that most of them were less than 3 mm. There were no pars flaccida and marginal perforations. Ossicular chain destruction was noted neither in temporal bone tomographic nor during intraoperative examinations. The mean (± SD) volumes of right and left ear mastoid air cells in patient and control groups were 6.92 ± 2.45 vs. 7.00 ± 2.59 cm³ and 9.04 ± 4.55 vs. 8.95 ± 4.53 cm³, respectively, and the differences were not statistically significant. It was found that the level of mastoid pneumatization has no statistically significant effect on tympanic membrane pathologies due to blast or other injuries.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Relationship between Traumatic Tympanic Membrane Perforations and Pneumatization of the Mastoid

Aktaş¹,

Kutlu

2000

ORL

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“…Factors such as the position of the ear in relation to the explosion, the state of the ear canal, and whether the explosion occurred in a confined space can influence the severity of damage to the ear [11,13]. The most visible type of blast-induced auditory injuries occur in the physical structures of the middle and inner ear, which include tympanic membrane perforations, ossicular disruptions, and symptoms generated from insult to the vestibular components [5,12,[14][15][16][17]. Damage to auditory components of the inner ear is of primary interest because it may be permanent and cause persistent symptoms of tinnitus [18][19][20] and hearing loss [6,17,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Development of a comprehensive Blast-Related Auditory Injury Database (BRAID)

Joseph¹,

Horton

Clouser

et al. 2016

J Rehabil Res Dev

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Abstract-The Department of Defense Hearing ConservationProgram provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of demographic, audiometric, point of injury, and medical outcome data, with the primary aim of developing a long-standing and integrated capability for the surveillance, assessment, and investigation of blast-related hearing outcomes. Methods used to develop the dataset are described. Encompassing more than 16,500 Navy and Marine Corps personnel, the Blast-Related Auditory Injury Database (BRAID) includes individuals with a blast-related injury and nonblast control subjects. Using baseline and postdeployment hearing threshold data, a retrospective analysis of the cohort revealed that the rate of hearing loss for the injured servicemembers was 39%. The BRAID will be useful for studies that assess hearing patterns following deployment-related injury, such as blast exposures, that facilitate exploration of health outcomes and whether they are predictive of audiometric disposition and that help establish hearing loss prevention strategies and program policies for affected military commands and servicemembers.

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Audiometric Configurations Following Exposure to Explosions

Perez¹,

Gatt²,

Cohen³

2000

Arch Otolaryngol Head Neck Surg

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There does not appear to be a single typical audiometric configuration in patients exposed to explosions. The slope and dip configurations are most frequently seen and are approximately equal in their incidence. This observation may lead to better understanding damage to the inner ear as a result of an explosion. This study is distinctive because of the large number of audiograms obtained and the fact that most of them were obtained immediately after the explosion.

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Blast injury of the auditory system: a review of the mechanisms and pathology

Cited by 42 publications

References 20 publications

The Relationship between Traumatic Tympanic Membrane Perforations and Pneumatization of the Mastoid

The Relationship between Traumatic Tympanic Membrane Perforations and Pneumatization of the Mastoid

Development of a comprehensive Blast-Related Auditory Injury Database (BRAID)

Audiometric Configurations Following Exposure to Explosions

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