[Therapy of middle ear injuries caused by explosive devices].

Forty nine wounded with the explosive injury of the middle ear were treated. The largest number of injuries were ruptures of the ear drum (79.35%), followed by the break of the ossicular chain (15.87%) and the fractures of the mastoid, along with the paralysis of the facial nerve (4.77%). In therapeutic procedure the reposition and connection of the eardrum parts and 'patch' technique were performed, and in case of perforation persistence longer than four months myringoplasty was done. Injuries of the auditory bones were solved by ossiculoplasty, and injuries of facial nerve by decompression and neuro suture. In 66% spontaneous healing of rupture occurred and the ossicular chain was successfully fixed in 80% of injuries while the reparation of the facial nerve was partially achieved. The acute secondary infection developed in 18% and the chronic otitis in 10% of cases. The early reposition of the eardrum rupture is recommended due to infection prevention of the middle ear and in order to stimulate the spontaneous improvement, while the surgical treatment is recommended in cases with persistent rupture or conductive loss of hearing lasting longer than four months.