Mrena Roderik, Pääkkönen Rauno, Bäck Leif, Pirvola Ulla, Ylikoski Jukka
Department of ORL, Helsinki University Central Hospital, Helsinki, Finland.
Acta Otolaryngol. 2004 Oct;124(8):946-52. doi: 10.1080/00016480310017045.
On 11 October, 2002, in the Myyrmanni shopping mall, Vantaa city, Finland, an explosion by a suicide bomber killed 7 people and injured at least 160,44 of whom had ear trauma. We investigated the acute and subacute otologic consequences of the explosion.
Otologic examination of the 29 patients treated for ear trauma at the ENT clinic of the University Hospital of Helsinki was performed during the first month after the explosion, and a questionnaire was completed regarding subjective aural symptoms. Symptoms occurring directly after the explosion and for up to 1 month afterwards were assessed.
Of the 29 patients, 66% had tinnitus as the initial symptom, 55% hearing loss, 41% pain in the ears and 28% sound distortion. Tinnitus and hearing loss in combination were experienced by 12 patients (41%). Eight patients who had been situated<10 m from the center of the explosion had a rupture of the tympanic membrane. This supported the initial evaluation by the authorities that the bomb had consisted of approximately 3 kg ammonium nitrate, equivalent to approximately 0.5 kg of trinitrotoluene. It was estimated that some kind of ear injury was likely for individuals situated<70 m from the center of the explosion.
People often think that tinnitus and hearing impairment are naturally occurring phenomena after blast exposure, and if their symptoms resolve they do not seek medical advice. However, some of them may have substantial hearing impairment, particularly at high frequencies. Otologic consultation, or at least an audiometric screening test to exclude hearing impairment, should be performed regardless of symptoms, on the basis of exposure data only. Some symptoms, such as tinnitus and hearing loss, may be permanent consequences of a blast injury and their effect on quality of life may be substantial.
2002年10月11日，在芬兰万塔市的米尔曼尼购物中心，一名自杀式炸弹袭击者引发的爆炸造成7人死亡，至少160人受伤，其中44人有耳部创伤。我们对此次爆炸造成的急性和亚急性耳科后果进行了调查。
对在赫尔辛基大学医院耳鼻喉科诊所接受耳部创伤治疗的29名患者在爆炸后的第一个月内进行了耳科检查，并完成了一份关于主观耳部症状的问卷。对爆炸后立即出现以及之后长达1个月内出现的症状进行了评估。
29名患者中，66%以耳鸣为初始症状，55%有听力损失，41%耳部疼痛，28%有声音失真。12名患者（41%）同时出现耳鸣和听力损失。8名位于距爆炸中心<10米处的患者鼓膜破裂。这支持了当局最初的评估，即炸弹由约3千克硝酸铵组成，相当于约0.5千克三硝基甲苯。据估计，位于距爆炸中心<70米处的人员可能会受到某种耳部损伤。
人们通常认为耳鸣和听力障碍是爆炸暴露后的自然现象，如果症状缓解，他们不会寻求医疗建议。然而，他们中的一些人可能有严重的听力障碍，尤其是在高频段。无论有无症状，都应仅根据暴露数据进行耳科咨询，或至少进行听力筛查测试以排除听力障碍。一些症状，如耳鸣和听力损失，可能是爆炸伤的永久性后果，其对生活质量的影响可能很大。
