Otologic manifestations from blast injuries among military personnel in Thailand

Klamkam, Pana; Jaruchinda, Pariyanan; Nivatwongs, Saisuree; Muninnobpamasa, Tarit; Harnchumpol, Pongthep; Nirattisai, Supattaree; Moungthong, Greetha

doi:10.1016/j.amjoto.2012.12.007

Cited by 10 publications

(18 citation statements)

References 9 publications

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“…The extent of damage is in parallel with the severity of explosion and the distance to the site of explosion. In contrast, the symptoms are associated with the affected anatomic region (6)(7)(8). Injuries involving separate or multiple anatomic regions can be observed in the external ear, middle ear, and inner ear.…”

Section: Discussionmentioning

confidence: 93%

“…However, while continuous or intermittent exposure to loud sound is observed in acoustic trauma, blast trauma includes a single and sudden high-pressure exposure (1). The exposure to blast trauma in indoor places and close distance to the site of explosion particularly increases the risk of sensorineural hearing loss (8). After blast trauma, vestibular symptoms can be observed more rarely, but the reason for that is often head trauma and perilymph fistula or superior semicircular canal dehiscence and should be remembered in cases having valid peripheral vertigo (7-9).…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

Aslıer

Ngy

2017

Turk Arch Otorhinolaryngol

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Objective: The aim of this study is to identify the otologic injuries due to handmade explosive-welded blast travma in the law enforcement officers during the combat operations in the curfew security region and to specify the disorders that Otolaryngology and Head Neck Surgery (OHNS) physicians can face during such operations. Methods:Medical records of patients in law enforcement who were initially treated by OHNS physicians of Silopi State Hospital during combat operations, between December 14, 2015 and January 15, 2016 were reviewed. Twenty-five patients with otologic injuries due to blast trauma were included in the study. Trauma characteristics, physical examination findings, and beginning treatments were identified.Results: Primary blast injury (PBI) was identified as the major disorder in all 24 cases. Tinnitus and hearing loss were the most frequent complaints. In physical examination, tympanic membrane perforations were found in four ears of three patients. Oral methylprednisolone in decreasing doses for 10 days was commenced as an initial treatment in patients with PBI. Secondary blast injury presented in the form of soft tissue damage in the auricular helix due to shrapnel pieces in one patient and a minor surgery was performed. Conclusion:Otologic injuries due to blast trauma may often develop during this type of combat operations. Otologic symptoms should be checked, otoscopic examination should be performed, and patients should consult OHNS physicians as soon as possible after trauma.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

Aslıer

Ngy

2017

Turk Arch Otorhinolaryngol

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“…In addition, however, other potential aetiologies require exclusion, such as peripheral vertigo, perilymph fistula, benign positional vertigo, and superior semicircular channel dehiscence occurring in conjunction with acute auditory loss. [19] Shah et al report that tinnitus, auditory loss and vertigo all rose at a significant level in those who had been in contact with a blast. [17] Vertigo predicts a worsened prognosis in cases of acute auditory loss.…”

Section: Discussionmentioning

confidence: 99%

The Analysis of Ear Traumas Caused From Hand-Made Explosives

Yıldız¹

2019

ENT Updates

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Objective: This study aims to examine what ear pathologies may occur in law-enforcement officials exposed to the effects of improvised explosive devices in regions where high levels of terrorist activity are expected. The issues faced by ENT and head and neck surgeons in treating such injuries are also examined. Methods: A retrospective review of examination findings and initial treatment offered was performed on clinical records written by specialists in Emergency Medicine, General Surgery, ENT and Head and Neck Surgery during a particular period (14/3/2016 to 25/7/2016) when a curfew was in operation. The records were taken from Nusaybin State Hospital. Some 260 individuals were included in the review, all of whom had ear problems related to exposure to an explosion. The particulars of the trauma incurred, the presenting complaint, examination findings, and initial surgical and medical treatment offered were determined for each case. Results: In 224 out of 260 cases, a primary explosion injury was recorded. The most frequently documented symptoms were tinnitus and loss of hearing. On physical Conclusion: Ear trauma secondary to improvised explosive devices is a common injury in law-enforcement officials. In individuals exposed to such hazards, symptoms of hearing problems should be sought, otoscopic and vestibular examination and audiological testing should be carried out at an early stage, and the patient should be referred to an ENT or Head and Neck Surgeon.

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“…In our cases, the severity of aural trauma was inversely related to the distance from the blast sitevictims closer to the site of blast showing larger perforations of TM and /or greater degree of hearing loss, but, Klamkam et al found that the correlation among the characteristic of the incident area, the weight of the explosive materials and the distance from the explosion is not statistically significant for SNHL, but age is-every 1 year increase in age resulted in a greater risk of SNHL of approximately 1.103 times, with statistical significance (p<0.01). 12 Status of torn edges of TM after the blast, whether everted, inverted, or neutral, has also been debated in the past. In our cases, mostly the edges were found to be everted.…”

Section: Discussionmentioning

confidence: 99%

Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

Kumar

Mishra

Mallick

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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Background: A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.Methods: We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated. Results: Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.Conclusions: Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.

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Otologic manifestations from blast injuries among military personnel in Thailand

Cited by 10 publications

References 9 publications

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

The Analysis of Ear Traumas Caused From Hand-Made Explosives

Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

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