Blast injury of the ear by massive explosion: a review of 41 cases

Régloix, S Ballivet de; Crambert, A.; Maurin, Olga; Lisan, Q.; Marty, Salome; Pons, Y.

doi:10.1136/jramc-2016-000733

Cited by 30 publications

(19 citation statements)

References 35 publications

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“…Perforation had low sensitivity for predicting serious or occult primary blast injury and, as such, was not a reliable biomarker [ 38 ]. Moreover, this and other studies have also shown that the absence of eardrum perforation does not appear to exclude other serious primary blast injuries [ 39 , 40 ].…”

Section: Historical Observations On Blast Injuries and Bintmentioning

confidence: 68%

Understanding blast-induced neurotrauma: how far have we come?

Černak

2017

Concussion

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Blast injuries, including blast-induced neurotrauma (BINT), are caused by blast waves generated during an explosion. Accordingly, their history coincides with that of explosives. Hence, it is intriguing that, after more than 1000 years of using explosives, our understanding of the pathological consequences of blast and body/brain interactions is extremely limited. Postconflict recovery mechanisms seemingly include the suppression of painful experiences, such as explosive injuries. Unfortunately, ignoring the knowledge generated by previous generations of scientists retards research progress, leading to superfluous and repetitive studies. This article summarizes clinical and experimental findings published about blast injuries and BINT following the wars of the 20th and 21th centuries. Moreover, it offers a personal view on potential factors interfering with the progress of BINT research working toward providing better diagnosis, treatment and rehabilitation for military personnel affected by blast exposure.

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Section: Historical Observations On Blast Injuries and Bintmentioning

confidence: 68%

Understanding blast-induced neurotrauma: how far have we come?

Černak

2017

Concussion

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“…6 Incidence of TM perforations in earlier studies has been reported as 16 -90%. [7][8][9][10][11] In our study, 55.47% of all surviving injured victims had evidence of ear trauma in the form of SNHL alone or with TM perforation. This is quite high and may be explained by higher quantity and high explosive nature of the material used in IEDs used in our area.…”

Section: Discussionmentioning

confidence: 95%

“…In the study by Ballivet et al, tympanoplasty was successful only in 44% cases. 11 The incomplete closures were with large perforations, those with foreign bodies (shrapnel), and in 1 with postoperative water exposure. 14…”

Section: Discussionmentioning

confidence: 99%

“…For example, in cases of Shah et al, only 8% had bilateral perforations while Ballivet et al reported bilateral perforation to be 2/3 rd of their cases. 10,11 As discussed above, the location of the blast may have shielding effect on one of the ear protecting it from injury while reflection of blast wave from a nearby surface may damage opposite ear also.…”

Section: Discussionmentioning

confidence: 99%

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Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

Kumar

Mishra

Mallick

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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Background: A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.Methods: We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated. Results: Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.Conclusions: Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.

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“…A review by our French military colleagues into blast ear has demonstrated that the significant functional signs caused by such events, but more interestingly that such signs are not correlated to otoscopic examinations 5. Blast Injury has been a significant source of morbidity for UK service personnel and significant research in terms of active ear prevention is still required before an acceptable form of personal protective equipment is found 6.…”

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confidence: 99%

Highlights of the edition

Breeze

2017

J R Army Med Corps

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Blast injury of the ear by massive explosion: a review of 41 cases

Cited by 30 publications

References 35 publications

Understanding blast-induced neurotrauma: how far have we come?

Understanding blast-induced neurotrauma: how far have we come?

Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

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