Taşlı Hamdi, Gökgöz Mert Cemal, Çoban Volkan Kenan, Nagiyev Zaur, Karakoç Ömer
Department of Otolaryngology, Head and Neck Surgery, Evliya Çelebi Training and Research Hospital, Kütahya-Turkey.
Department of Otolaryngology, Head and Neck Surgery, Manisa State Hospital, Manisa-Turkey.
Ulus Travma Acil Cerrahi Derg. 2021 Jan;27(1):79-84. doi: 10.14744/tjtes.2020.87639.
Blast-induced hearing loss is an acoustic trauma commonly caused by high-energy explosions of improvised explosive devices, and the auditory system may be affected by blast damage. This study aims to evaluate the protective effect of tympanic membrane perforation (TMP) on the inner ear against blast injury.
In this study, 43 adult patients who had suffered blast injury were divided into three subgroups: intact tympanic membranes in both ears, unilateral TMP, and bilateral TMP. Each patient underwent a comprehensive audiogram, including bone conduction, in the audiology department.
Evaluation was performed on 43 (100%) males with a mean age of 31.44±8.01 years (range, 18-52 years). When the type of hearing loss was evaluated separately for each ear, sensorineural hearing loss (SNHL) was observed in 31 (36%), high-frequency SNHL in 26 (30.2%), conductive hearing loss in eight (9.3%), and mixed type hearing loss in 21 (24.4%) ears. TMP was detected in 21 (48.8%) of 43 blast-injured patients, on the right side in four (9.3%) patients, on the left side in seven (16.3%), and bilateral in 10 (23.3%). When the type of acoustic trauma was evaluated, 15 (34.9%) patients were observed to have suffered from the explosion of an IED, 12 (30.2%) from weapon explosion, six (14%) were a vehicle bomb explosion, three (7%) were projectile missile explosion, three (7%) were mortar explosion, two (4.7%) were mine explosion, and two (4.7%) were exposed to the explosion in an armored vehicle (Table 1).
No significant difference was observed in the majority of the frequencies whether the tympanic membrane was perforated or not in the blast-injured patients and it was concluded that tympanic membrane perforation caused by blast injury had no protective effect on the inner ear.
爆震性听力损失是一种由简易爆炸装置的高能爆炸所致的听觉创伤，听觉系统可能会受到爆震损伤的影响。本研究旨在评估鼓膜穿孔（TMP）对内耳免受爆震损伤的保护作用。
在本研究中，43例遭受爆震损伤的成年患者被分为三个亚组：双耳鼓膜完整、单侧鼓膜穿孔和双侧鼓膜穿孔。每位患者均在听力科接受了包括骨导在内的全面听力图检查。
对43例（100%）男性患者进行了评估，平均年龄为31.44±8.01岁（范围18 - 52岁）。当分别对每只耳朵的听力损失类型进行评估时，31只耳朵（36%）出现感音神经性听力损失（SNHL）,26只耳朵（30.2%）出现高频SNHL，8只耳朵（9.3%）出现传导性听力损失，21只耳朵（24.4%）出现混合性听力损失。在43例爆震伤患者中，21例（48.8%）检测到鼓膜穿孔，右侧4例（9.3%）,左侧7例（16.3%）,双侧10例（23.3%）。当评估爆震创伤类型时，观察到15例（34.9%）患者因简易爆炸装置爆炸受伤，12例（30.2%）因武器爆炸受伤，6例（14%）因汽车炸弹爆炸受伤，3例（7%）因射弹爆炸受伤，3例（7%）因迫击炮爆炸受伤，2例（4.7%）因地雷爆炸受伤，2例（4.7%）在装甲车中遭受爆炸暴露（表1）。
在爆震伤患者中，无论鼓膜是否穿孔，大多数频率下均未观察到显著差异，得出爆震伤所致的鼓膜穿孔对内耳没有保护作用的结论。
