Hussain Saif Mohammed, Saeed Haider Kadhem, Ali Amjed Hayder
Lecturer at Al-Zahraa College of Medicine, University of Basrah, Basra, Iraq.
Otolaryngologist, Basra Teaching Hospital, Basra, Iraq.
Int Tinnitus J. 2022 Dec 1;26(2):122-126. doi: 10.5935/0946-5448.20220019.
There is many civilians and soldiers who exposed to explosions in Iraq each month and they need an otolaryngological and audiological assessment.
To recognize the possible auditory insults and the recovery period of the acquired damages that may resulted from explosion and help for planning of optimal management strategies of otological manifestations and prevent undesirable consequences.
A prospective, descriptive study included forty-seven patients who were exposed to blast injuries within two weeks came to otolaryngology unit in Basrah Teaching Hospital complaining from otological symptoms from July 2017 tell January 2019. Three periodic assessments were done for each patient. An initial evaluation was done in the 1st visit included a detailed history and examination to evaluate the symptoms and assess the associated non-otological injury. An otological examination were done for all patients in the three visits, included microscopic ear examination, photos for the perforated tympanic membrane were taken to grade the perforations depending on their surface area, Pure tone audiometry and tympanometry. Thirty-eight patients were available to follow up in the 2nd and 3rd visits.
All of the 47 patients were young and middle age male, hearing loss and tinnitus were the most presenting symptoms, which improved with time. Hearing impairment mostly in the high frequencies however there was improvement in the subsequent visits. The majority of patients (93.6%) presented with tympanic membrane perforation mostly grade I which usually healed spontaneously. There was a statistically significant associations between the degree of tympanic membrane perforation and associated nonotological injuries and with the explosions if occurred in closed space.
Blast related otological injury constitute the main cause of morbidity as the ear is the most sensitive organ to explosive blast injury. Hearing loss was the dominant symptoms at presentation mainly in high frequencies, but fortunately most of patients improved with time. Tympanic membrane perforation constituted the mostly seen sign, however spontaneous healing can be expected in the majority of cases.
伊拉克每月有许多平民和士兵遭受爆炸冲击，他们需要进行耳鼻喉科和听力学评估。
识别爆炸可能导致的听觉损伤以及所获损伤的恢复期，并协助制定耳部表现的最佳管理策略，预防不良后果。
一项前瞻性描述性研究纳入了47例在两周内遭受爆炸伤的患者，这些患者于2017年7月至2019年1月因耳部症状前往巴士拉教学医院耳鼻喉科就诊。对每位患者进行了三次定期评估。首次就诊时进行了初步评估，包括详细的病史询问和检查，以评估症状并评估相关的非耳部损伤。在三次就诊中对所有患者进行了耳部检查，包括耳镜检查、拍摄鼓膜穿孔照片以根据穿孔表面积对穿孔进行分级、纯音听力测定和鼓室图检查。38例患者在第二次和第三次就诊时可供随访。
47例患者均为中青年男性，听力损失和耳鸣是最常见的症状，这些症状随时间有所改善。听力损害主要发生在高频，但在随后的就诊中有所改善。大多数患者（93.6%）出现鼓膜穿孔，大多为I级，通常可自行愈合。鼓膜穿孔程度与相关非耳部损伤以及在封闭空间发生的爆炸之间存在统计学显著关联。
与爆炸相关的耳部损伤是发病的主要原因，因为耳朵是对爆炸冲击最敏感的器官。听力损失是就诊时的主要症状，主要发生在高频，但幸运的是大多数患者随时间有所改善。鼓膜穿孔是最常见的体征，然而大多数情况下可预期自行愈合。
