Blast-Induced Auditory Injury: From Peripheral Pathology to Central Neurodegeneration

Area of Science:

• Auditory Neuroscience
• Trauma Research
• Neurology

Background:

• Blast wave exposure is a leading cause of auditory and neurological injuries.
• The ear's vulnerability to intense mechanical forces makes it susceptible to blast trauma.
• Understanding multidimensional damage to the auditory system post-blast is critical.

Purpose of the Study:

• To review the multidimensional damage to the auditory system following blast events.
• To synthesize evidence on the range and nature of blast-induced auditory impairments.
• To identify research gaps and future directions in managing blast-related hearing loss.

Main Methods:

• Systematic literature search across major scientific databases (PubMed, Scopus, Web of Science, Google Scholar) from January 2000 to January 2025.
• Screening of 462 unique records, with 36 original research studies (animal, human, computational) meeting inclusion criteria.
• Quality assessment of included studies to ensure reliability of findings.

Main Results:

• Blast exposure results in widespread auditory impairment, from cochlear synaptopathy to central neurodegeneration.
• Blast-related injuries involve unique biomechanical forces distinct from conventional noise trauma.
• Repeated exposures lead to chronic issues like tinnitus and speech-in-noise difficulties.

Conclusions:

• Effective management of blast-induced hearing loss necessitates a multidisciplinary approach.
• Further research should focus on validating sensitive biomarkers for early diagnosis.
• Development of targeted neuroprotective therapies is essential for future treatment strategies.