Oleksiak Michael, Smith Bridget M, St Andre Justin R, Caughlan Carly M, Steiner Monica
1Department of Veterans Affairs, Center for Management of Complex Chronic Care, Spinal Cord Injury Quality Enhancement Research Initiative, Edward Hines Jr VA Hospital, Hines, IL 60141, USA.
J Rehabil Res Dev. 2012;49(7):995-1004. doi: 10.1682/jrrd.2011.01.0001.
We examined the prevalence, severity, etiology, and treatment of audiology problems among Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans with mild traumatic brain injury (TBI). A retrospective chart review was performed of 250 Veterans with mild TBI. Results of a comprehensive second-level mild TBI evaluation and subsequent visits to audiology were evaluated. We found the vast majority (87%) of Veterans reported some level of hearing disturbance and those involved in blast injuries reported a higher incidence of hearing disturbance than those with other injury etiologies. Audiology referrals were given to 75 Veterans and 37 attended. At this visit, Veterans reported tinnitus (75.7%) and hearing loss (59.8%). Nearly half (48.6%) of Veterans were diagnosed with conductive hearing loss, sensorineural hearing loss, or central auditory dysfunction. An additional 24.3% of Veterans had subclinical levels of auditory dysfunction. Our study has highlighted the increased prevalence of hearing loss among OIF/OEF Veterans and, thus, the need for appropriate referrals and treatment. Strategies to address perceived stigma associated with hearing loss may increase attendance at follow-up visits. Additionally, while only a third of audiograms were found to be abnormal, advanced testing resulted in a significant percentage of our population being diagnosed with auditory dysfunction.
我们研究了伊拉克自由行动/持久自由行动(OIF/OEF)中患有轻度创伤性脑损伤(TBI)的退伍军人听力问题的患病率、严重程度、病因及治疗情况。对250名患有轻度TBI的退伍军人的病历进行了回顾性分析。评估了全面的二级轻度TBI评估结果以及随后的听力检查情况。我们发现绝大多数(87%)退伍军人报告有一定程度的听力障碍,与其他损伤病因的退伍军人相比,遭受爆炸伤的退伍军人听力障碍发生率更高。75名退伍军人被转诊至听力科,37人就诊。在此次就诊时,退伍军人报告有耳鸣(75.7%)和听力损失(59.8%)。近一半(48.6%)退伍军人被诊断为传导性听力损失、感音神经性听力损失或中枢听觉功能障碍。另外24.3%的退伍军人存在亚临床水平的听觉功能障碍。我们的研究突出了OIF/OEF退伍军人中听力损失患病率的增加,因此需要进行适当的转诊和治疗。解决与听力损失相关的耻辱感的策略可能会增加随访就诊率。此外,虽然仅发现三分之一的听力图异常,但进一步检测导致我们研究人群中有相当比例被诊断为听觉功能障碍。