Bonfort G, Billot D, Trendel D, Salf E, Lindas P, Barberot J P
Rev Laryngol Otol Rhinol (Bord). 2014;135(1):25-31.
Studying the epidemiology, the evolutionary audiometric profile and the after-effects of acute acoustic trauma managed in military environment. Assessing the influence beyond the audiometric recovery of earplugs, precocity of the treatment and hyperbaric oxygen therapy.
This retrospective cohort gathered 225 military cases of acute acoustic trauma hospitalized between 2003 and 2008. The cochlear supportive therapy associated intravenous methyl-prednisolone and pentoxyfilline, completed sometimes with hyperbaric oxygen therapy. The evolution was appreciated with pure-tone audiometry at the admission, at the end of hospitalization and one month after. Perceptive deafness and recovery shifts were statically calculated on 109 ears.
On the 225 cases, 90% were males, middle-aged of 23 years. Initially 95% of the patients complained about tinnitus, associated with hearing loss felt for 71%. The left ear was more frequently affected. The initial audiometric loss was average of 34 dB HL, concentrated on 4000 and 6000 Hz frequencies. The therapy allowed an average recovery of +18,3 dB in a month. The audiometric sequela concerned 40% of the cases, and residual tinnitus a third. These rates were significantly higher with people whose initial hearing loss average exceeded 40 dB HL. Concerning the audiometric recovery and the after-effects, no significantly difference was found between the groups treated before or after 12 hours. There were either no difference with the earplugs and hyperbaric oxygen groups.
Despite the effectiveness of early corticotherapy, after-effects of acute acoustic trauma remain frequent and invalidating. Its prevention suffers from non-observance and malposition of earplugs.
研究军事环境中急性声创伤的流行病学、听力测定演变情况及后遗症。评估耳塞、治疗时机和高压氧治疗对听力恢复的影响。
该回顾性队列研究收集了2003年至2008年间住院的225例军事急性声创伤病例。耳蜗支持疗法联合静脉注射甲基泼尼松龙和己酮可可碱，有时辅以高压氧治疗。在入院时、住院结束时及出院后1个月通过纯音听力测定评估病情进展。对109只耳朵进行了感音神经性聋和恢复变化的统计学计算。
在225例病例中，90%为男性，平均年龄23岁。最初，95%的患者抱怨耳鸣，71%伴有听力损失。左耳更常受累。初始听力损失平均为34 dB HL，集中在4000和6000 Hz频率。治疗1个月后平均恢复了+18.3 dB。听力测定后遗症涉及40%的病例，三分之一有残留耳鸣。初始听力损失平均超过40 dB HL的患者，这些发生率显著更高。关于听力恢复和后遗症，在12小时之前或之后接受治疗的组之间未发现显著差异。耳塞组和高压氧组之间也没有差异。
尽管早期皮质激素治疗有效，但急性声创伤的后遗症仍然常见且使人致残。其预防因耳塞使用不当和佩戴位置错误而受到影响。
