Orji F T
Department of Otolarlaryngology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Niger J Med. 2009 Oct-Dec;18(4):365-9. doi: 10.4314/njm.v18i4.51227.
To examine the clinical features and causes of non-explosive blast injury to the ear, as well as the frequency of the State police involvement.
Prospective clinical study of consecutive patients with traumatic tympanic membrane perforations resulting from non-explosive blast trauma to the ear without history of previous middle ear disease who attended ENT clinic of Federal Medical Center Umuahia. Clinical features and causes of non-explosive blast injury to ear; healing outcome at 2, 4, 8, and 12 weeks; perforation size versus healing outcome and cause of injury were the main outcomes measured.
Five hundred and ninety three new patients with aural disease were analysed. Sixty-one patients, (38 males and 23 females), aged 10-56 years had tympanic membrane perforation from non-explosive blast injury to the ear. The commonest symptoms were hearing loss (64%), tinnitus (61%), and ear ache (57%). The causes of injury were: slap against the ear by State police (31%), spouse (28%), armed bandits (18%), school teachers (8%), parents (5%), and blow against the ear during street fight (10%). Ninety two percent of the perforations healed spontaneously Healing was associated with significant closure of air bone gap (t = 15.08; p < 0.01). Non-healing of perforation was significantly associated with the large perforations occupying estimated 50% or more of the entire tympanic membrane area (chi2 = 8.67; p = 0.003).
The ear is very susceptible to injury from non-explosive blast trauma. There was a high spontaneous healing rate of the resulting tympanic membrane perforation, favoring conservative management in most of the case. Non-healing was associated with large-sized perforations. Abusive slap by the State police men was the commonest cause of non-explosive blast injury to the tympanic membrane. Our results are hoped to stimulate a change in the attitude of the culprits and lead to a reduction in the incidence of avoidable TM perforations from slap assaults.
研究耳部非爆炸性冲击波损伤的临床特征、病因以及州警察涉入事件的频率。
对连续就诊于联邦医疗中心乌马希亚耳鼻喉科门诊的患者进行前瞻性临床研究，这些患者因耳部非爆炸性冲击波创伤导致鼓膜穿孔，且既往无中耳疾病史。耳部非爆炸性冲击波损伤的临床特征和病因；2周、4周、8周和12周时的愈合结果；穿孔大小与愈合结果及损伤原因是主要测量结果。
分析了593例新发耳部疾病患者。61例患者（38例男性和23例女性），年龄在10 - 56岁之间，因耳部非爆炸性冲击波损伤导致鼓膜穿孔。最常见的症状是听力损失（64%）、耳鸣（61%）和耳痛（57%）。损伤原因包括：州警察扇耳光（31%）、配偶（28%）、武装匪徒（18%）、学校教师（8%）、父母（5%）以及街头斗殴时耳部受打击（10%）。92%的穿孔可自发愈合。愈合与气骨导间距显著缩小相关（t = 15.08；p < 0.01）。穿孔未愈合与占据整个鼓膜面积估计50%或更多的大穿孔显著相关（χ2 = 8.67；p = 0.003）。
耳部极易受到非爆炸性冲击波创伤。由此导致的鼓膜穿孔自发愈合率较高，在大多数情况下支持保守治疗。未愈合与大尺寸穿孔相关。州警察的虐待性扇耳光是鼓膜非爆炸性冲击波损伤最常见的原因。我们的研究结果有望促使肇事者态度转变，并减少因扇耳光袭击导致的可避免鼓膜穿孔的发生率。
