Mizutari Kunio
Department of Otolaryngology, Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
Curr Opin Otolaryngol Head Neck Surg. 2019 Oct;27(5):376-380. doi: 10.1097/MOO.0000000000000563.
The incidence of blast injuries has increased, and the ear is the highest risk organ. Ear injury induced by blast exposure is important in both military and civilian conditions. The permanent hearing loss caused by blast exposure is associated with a decline in the quality of life. In this review, I describe recent therapeutic strategies for each of the ear pathologies caused by blast exposure.
For tympanic membrane perforation after blast exposure, basic fibroblast growth factor (bFGF) has been used as a less invasive treatment to repair the tympanic membrane. The closure rates of tympanic membrane perforations treated with bFGF were reported to be comparable to those following conventional tympanoplasty.For sensorineural hearing loss after blast exposure, treatment with neurotrophic factors, such as nerve growth factor (NGF) or neurotrophin-3, antioxidants, and Atoh1 induction have recently been applied, and some of them were considered for clinical application.
Recent advances of therapeutics for blast-induced hearing loss, based on their pathologies, have been outlined. There are several promising therapeutic approaches for both middle and inner ear disorders after blast exposure; however, further research is needed to establish new treatments for blast-induced hearing dysfunction.
爆炸伤的发生率有所上升，耳部是受影响风险最高的器官。爆炸暴露所致耳部损伤在军事和民用环境中均具有重要意义。爆炸暴露导致的永久性听力损失与生活质量下降相关。在本综述中，我描述了针对爆炸暴露引起的各种耳部病变的近期治疗策略。
对于爆炸暴露后的鼓膜穿孔，碱性成纤维细胞生长因子（bFGF）已被用作一种侵入性较小的治疗方法来修复鼓膜。据报道，用bFGF治疗的鼓膜穿孔闭合率与传统鼓膜成形术后的闭合率相当。对于爆炸暴露后的感音神经性听力损失，近期已应用神经营养因子（如神经生长因子（NGF）或神经营养素-3）、抗氧化剂以及Atoh1诱导治疗，其中一些已被考虑用于临床。
基于病理情况概述了爆炸所致听力损失治疗的最新进展。对于爆炸暴露后的中耳和内耳疾病，有几种有前景的治疗方法；然而，需要进一步研究以建立针对爆炸所致听力功能障碍的新治疗方法。
