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An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices

Year 2019, Volume: 9 Issue: 2, 115 - 121, 08.08.2019
https://doi.org/10.32448/entupdates.576616

Abstract

Objective: This study aims to examine what ear pathologies may occur in law-enforcement officials exposed to the effects of improvised explosive devices in regions where high levels of terrorist activity are expected. The issues faced by ENT and head and neck surgeons in treating such injuries are also examined.

Methods: A retrospective review of examination findings and initial treatment offered was performed on clinical records written by specialists in Emergency Medicine, General Surgery, ENT and Head and Neck Surgery during a particular period (14/3/2016 to 25/7/2016) when a curfew was in operation. The records were taken from Nusaybin State Hospital. Some 260 individuals were included in the review, all of whom had ear problems related to exposure to an explosion. The particulars of the trauma incurred, the presenting complaint, examination findings, and initial surgical and medical treatment offered were determined for each case.

Results: In 224 out of 260 cases, a primary explosion injury was recorded. The most frequently documented symptoms were tinnitus and loss of hearing. On physical examination, 25 individuals had traumatic perforation of the tympanic membrane. 12 cases featured nystagmus and dizziness and fistula testing was positive in 2 cases, possibly as a result of a perilymph fistula. In case where abrupt hearing loss was apparent on audiological testing, intravenous methylprednisolone was administered at a dosage of 1mg/kg. Cases of multiple trauma were referred onto more specialised clinical units. For cases where hearing loss was mild and the only symptom, the treatment was a reducing dose of oral methylprednisolone over twelve days. Thirty-six individuals were diagnosed with secondary trauma from the explosion. Such trauma included soft tissue and bony injury in the auricular, pre- and post-auricular regions, and was treated by surgery.

Conclusion: Ear trauma secondary to improvised explosive devices is a common injury in law-enforcement officials. In individuals exposed to such hazards, symptoms of hearing problems should be sought, otoscopic and vestibular examination and audiological testing should be carried out at an early stage, and the patient should be referred to an ENT or Head and Neck Surgeon.

References

  • 1. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 20-2.
  • 2. DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med 2005;352:1335-42.
  • 3. Wightman JM, Gladish SL. Explosions and blast injuries. Ann Emerg Med 2001;37:664-78.
  • 4. Cohen JT, Ziv G, Bloom J, Zikk D, Rapoport Y, Himmelfarb MZ. Blast injury of the ear in a confined space explosion: auditory and vestibular evaluation. Isr Med Assoc J 2002;4:559-62.
  • 5. Mayo A, Kluger Y. Blast-induced injury of air-containing organs. ADF Health 2006;7:40-4.
  • 6. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 32 -4.
  • 7. VanRijswijk JB, Dubach P. Binaural Tympanic-Membrane Perforations after Blast Injury. N Engl J Med 2017;376:e41.
  • 8. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 36.
  • 9. Ritenour AE, Wickley A, Ritenour JS, et al. Tympanic membrane perforation and hearing loss from blast overpressure in Operation Enduring Freedom and Operation Iraqi Freedom wounded. J Trauma 2008;64:174-8.
  • 10. Sridhara SK, RiveraA, Littlefield P. Tympanoplasty for blast-induced perforations: the Walter Reed experience. Otolaryngol Head Neck Surg 2013;148:103-7.
  • 11. Scalzitti NJ, Pfannenstiel TJ. A lightning strike causing a cholesteatoma: a unique form of otologic blast injury. Otol Neurotol 2014;35:298-300.
  • 12. Remenschneider AK, Lookabaugh S, Aliphas A, et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol 2014;35:1825-34.
  • 13. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 313.
  • 14. Cho SI, Gao SS, Xia A, et al. Mechanisms of hearing loss after blast injury to the ear. PLoS One 2013;8:67618.
  • 15. Jagade MV, Patil RA, Suhail IS, et al. Bomb blast injury: effect on middle and inner ear. Indian J Otolaryngol Head Neck Surg 2008;60:324-30.
  • 16. Kemaloglu Y, Tutar H. Noise Induced Hearing Loss and Acoustic Trauma. J E.N.T.-Special Topics 2013;6:44-54.
  • 17. Shah A, Ayala M, Capra G, Fox D, Hoffer M Otologic assessment of blast and nonblast injury in returning Middle East-deployed service members. Laryngoscope 2014;124:272-7.
  • 18. Gok U, Kapusuz Z, Sapmaz E, Yildiz M. Relation of Pure Tone Odyograms and Prognosis in Sudden Hearing Loss.[Article in Turkish] Firat Med J 2007;12:13-6.
  • 19. Klamkam P, Jaruchinda P, Nivatwongs S, et al. Otologic manifestations from blast injuries among military personnel in Thailand. Am J Otolaryngol 2013;34:287-91.
  • 20. Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
Year 2019, Volume: 9 Issue: 2, 115 - 121, 08.08.2019
https://doi.org/10.32448/entupdates.576616

Abstract

References

  • 1. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 20-2.
  • 2. DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med 2005;352:1335-42.
  • 3. Wightman JM, Gladish SL. Explosions and blast injuries. Ann Emerg Med 2001;37:664-78.
  • 4. Cohen JT, Ziv G, Bloom J, Zikk D, Rapoport Y, Himmelfarb MZ. Blast injury of the ear in a confined space explosion: auditory and vestibular evaluation. Isr Med Assoc J 2002;4:559-62.
  • 5. Mayo A, Kluger Y. Blast-induced injury of air-containing organs. ADF Health 2006;7:40-4.
  • 6. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 32 -4.
  • 7. VanRijswijk JB, Dubach P. Binaural Tympanic-Membrane Perforations after Blast Injury. N Engl J Med 2017;376:e41.
  • 8. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 36.
  • 9. Ritenour AE, Wickley A, Ritenour JS, et al. Tympanic membrane perforation and hearing loss from blast overpressure in Operation Enduring Freedom and Operation Iraqi Freedom wounded. J Trauma 2008;64:174-8.
  • 10. Sridhara SK, RiveraA, Littlefield P. Tympanoplasty for blast-induced perforations: the Walter Reed experience. Otolaryngol Head Neck Surg 2013;148:103-7.
  • 11. Scalzitti NJ, Pfannenstiel TJ. A lightning strike causing a cholesteatoma: a unique form of otologic blast injury. Otol Neurotol 2014;35:298-300.
  • 12. Remenschneider AK, Lookabaugh S, Aliphas A, et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol 2014;35:1825-34.
  • 13. Giannou C, Baldan M, Molde A. War Surgery-2, 1st edition (trans) Eryılmaz M. Geneva: ICRC; 2013. pp. 313.
  • 14. Cho SI, Gao SS, Xia A, et al. Mechanisms of hearing loss after blast injury to the ear. PLoS One 2013;8:67618.
  • 15. Jagade MV, Patil RA, Suhail IS, et al. Bomb blast injury: effect on middle and inner ear. Indian J Otolaryngol Head Neck Surg 2008;60:324-30.
  • 16. Kemaloglu Y, Tutar H. Noise Induced Hearing Loss and Acoustic Trauma. J E.N.T.-Special Topics 2013;6:44-54.
  • 17. Shah A, Ayala M, Capra G, Fox D, Hoffer M Otologic assessment of blast and nonblast injury in returning Middle East-deployed service members. Laryngoscope 2014;124:272-7.
  • 18. Gok U, Kapusuz Z, Sapmaz E, Yildiz M. Relation of Pure Tone Odyograms and Prognosis in Sudden Hearing Loss.[Article in Turkish] Firat Med J 2007;12:13-6.
  • 19. Klamkam P, Jaruchinda P, Nivatwongs S, et al. Otologic manifestations from blast injuries among military personnel in Thailand. Am J Otolaryngol 2013;34:287-91.
  • 20. Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Muhammed Gazi Yıldız 0000-0002-1880-0685

Publication Date August 8, 2019
Submission Date June 12, 2019
Acceptance Date June 13, 2019
Published in Issue Year 2019 Volume: 9 Issue: 2

Cite

APA Yıldız, M. G. (2019). An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices. ENT Updates, 9(2), 115-121. https://doi.org/10.32448/entupdates.576616
AMA Yıldız MG. An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices. ENT Updates. August 2019;9(2):115-121. doi:10.32448/entupdates.576616
Chicago Yıldız, Muhammed Gazi. “An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices”. ENT Updates 9, no. 2 (August 2019): 115-21. https://doi.org/10.32448/entupdates.576616.
EndNote Yıldız MG (August 1, 2019) An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices. ENT Updates 9 2 115–121.
IEEE M. G. Yıldız, “An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices”, ENT Updates, vol. 9, no. 2, pp. 115–121, 2019, doi: 10.32448/entupdates.576616.
ISNAD Yıldız, Muhammed Gazi. “An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices”. ENT Updates 9/2 (August 2019), 115-121. https://doi.org/10.32448/entupdates.576616.
JAMA Yıldız MG. An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices. ENT Updates. 2019;9:115–121.
MLA Yıldız, Muhammed Gazi. “An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices”. ENT Updates, vol. 9, no. 2, 2019, pp. 115-21, doi:10.32448/entupdates.576616.
Vancouver Yıldız MG. An Analysis Of Ear Trauma Occurring Secondary To Improvised Explosive Devices. ENT Updates. 2019;9(2):115-21.