Yehudai Noam, Fink Nir, Shpriz Manor, Marom Tal
Medical Corps, Israel Defense Forces, Tel Hashomer, Israel.
Department of Otolaryngology-Head and Neck Surgery, Bnai Zion Medical Center, Technion-Bruce Rappaport School of Medicine, Haifa, Israel.
J Am Acad Audiol. 2017 May;28(5):436-443. doi: 10.3766/jaaa.16043.
During military actions, soldiers are constantly exposed to various forms of potentially harmful noises. Acute acoustic trauma (AAT) results from an impact, unexpected intense noise ≥140 dB, which generates a high-energy sound wave that can damage the auditory system.
We sought to characterize AAT injuries among military personnel during operation "Protective Edge," to analyze the effectiveness of hearing protection devices (HPDs), and to evaluate the benefit of steroid treatment in early-diagnosed AAT injury.
We retrospectively identified affected individuals who presented to military medical facilities with solitary or combined AAT injuries within 4 mo following an intense military operation, which was characterized with an abrupt, intensive noise exposure (July-December 2014).
A total of 186 participants who were referred during and shortly after a military operation with suspected AAT injury.
HPDs, oral steroids.
Data extracted from charts and audiograms included demographics, AAT severity, worn HPDs, first and last audiograms and treatment (if given). The Student's independent samples t test was used to compare continuous variables. All tests were considered significant if p values were ≤0.05.
A total of 186 participants presented with hearing complaints attributed to AAT: 122, 39, and 25 were in duty service, career personnel, and reservists, with a mean age of 21.1, 29.2, and 30.4 yr, respectively. Of them, 92 (49%) participants had confirmed hearing loss in at least one ear. Hearing impairment was significantly more common in unprotected participants, when compared with protected participants: 62% (74/119) versus 45% (30/67), p < 0.05. Tinnitus was more common in unprotected participants when compared with protected participants (75% versus 49%, p = 0.04), whereas vertigo was an uncommon symptom (5% versus 2.5%, respectively, p > 0.05). In the 21 participants who received steroid treatment for early-diagnosed AAT, bone-conduction hearing thresholds significantly improved in the posttreatment audiograms, when compared with untreated participants (p < 0.01, for 1-4 kHz).
AAT is a common military injury, and should be diagnosed early to minimize associated morbidity. HPDs were proven to be effective in preventing and minimizing AAT hearing sequelae. Steroid treatment was effective in AAT injury, if initiated within 7 days after noise exposure.
在军事行动期间，士兵不断暴露于各种形式的潜在有害噪音中。急性声创伤（AAT）由冲击、意外的强度≥140分贝的高强度噪音引起，这种噪音会产生能损害听觉系统的高能声波。
我们试图描述“保护边缘”行动期间军事人员的急性声创伤损伤情况，分析听力保护装置（HPD）的有效性，并评估类固醇治疗对早期诊断的急性声创伤损伤的益处。
我们回顾性地确定了在一次激烈军事行动后4个月内到军事医疗设施就诊的患有孤立性或合并性急性声创伤损伤的受影响个体，该军事行动的特点是突然、高强度的噪音暴露（2014年7月至12月）。
共有186名在军事行动期间及行动后不久因疑似急性声创伤损伤而被转诊的参与者。
听力保护装置、口服类固醇。
从病历和听力图中提取的数据包括人口统计学信息、急性声创伤严重程度、佩戴的听力保护装置、首次和末次听力图以及治疗情况（如果进行了治疗）。采用学生独立样本t检验比较连续变量。如果p值≤0.05，则所有检验均被认为具有显著性。
共有186名参与者因急性声创伤出现听力主诉：在职军人、职业军人和预备役军人分别有122名、39名和25名，平均年龄分别为21.1岁、29.2岁和30.4岁。其中，92名（49%）参与者至少一只耳朵确诊有听力损失。与佩戴保护装置的参与者相比，未佩戴保护装置的参与者听力障碍明显更常见：62%（74/119）对45%（30/67），p<0.05。与佩戴保护装置的参与者相比，未佩戴保护装置的参与者耳鸣更常见（75%对49%，p = 0.04），而眩晕是一种不常见的症状（分别为5%对2.5%，p>0.05）。在21名因早期诊断的急性声创伤接受类固醇治疗的参与者中，与未接受治疗的参与者相比，治疗后听力图中的骨导听力阈值显著改善（1 - 4千赫时，p<0.01）。
急性声创伤是一种常见的军事损伤，应尽早诊断以尽量减少相关发病率。听力保护装置被证明在预防和减少急性声创伤听力后遗症方面有效。如果在噪音暴露后7天内开始使用，类固醇治疗对急性声创伤损伤有效。
