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Long-Term Sensorineural Hearing Loss in Patients With Blast-Induced Tympanic Membrane Perforations
Philip D Littlefield1, Douglas S Brungart2
1Department of Otolaryngology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Ear and Hearing
|December 30, 2019
Summary
Most patients with blast-induced eardrum perforations experience mild sensorineural hearing loss (SNHL). However, some develop significant SNHL, with ossicular discontinuity predicting worse outcomes.
Area of Science:
- Otolaryngology
- Audiology
- Military Medicine
Background:
- Blast injuries can cause tympanic membrane (TM) perforations.
- Sensorineural hearing loss (SNHL) is a potential complication of blast trauma.
- Understanding SNHL characteristics after blast injury is crucial for treatment and prognosis.
Purpose of the Study:
- To characterize sensorineural hearing loss (SNHL) in patients with blast-induced tympanic membrane (TM) perforations requiring surgery.
- To identify predictors of SNHL severity in this patient population.
Main Methods:
- Retrospective review of hearing outcomes in patients undergoing tympanoplasty for combat blast-induced TM perforations.
- Inclusion of 49 patients with preinjury, preoperative, and long-term audiograms.
- Exclusion of patients with pre-existing hearing loss.
Main Results:
- 70% of perforated ears had SNHL of 10 dB or less; 8% had threshold shifts >30 dB.
- Ossicular discontinuity was the strongest predictor of severe or profound hearing loss.
- SNHL correlated with bilateral injury and perforation size; larger on the perforated side.
Conclusions:
- Blast-induced TM perforations show a bimodal SNHL distribution: most recover, but some have significant threshold shifts.
- Blast-exposed ears often exhibit flatter audiograms than typical military personnel with similar hearing loss.
- Ossicular discontinuity is a key factor in predicting severe SNHL post-blast injury.
