Otologic assessment of blast and nonblast injury in returning middle east‐deployed service members

Shah, Anil N.; Ayala, M.A.; Capra, Gregory; Fox, Dov; Hoffer, Michael E.

doi:10.1002/lary.24169

Cited by 39 publications

(22 citation statements)

References 14 publications

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“…While the prevalence of tinnitus normally increases with age, noise exposure is believed to be the most common cause of tinnitus in humans (Cooper, 1994). The prevalence of tinnitus is increased by several-fold among military populations, especially those who have served in battle zones (Shah et al, 2014). A recent study analyzed the incidence of hearing loss and tinnitus in a group of people who work in a noisy environment and found that approximately 40% of them had tinnitus (Hong et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Brain Metabolic Changes in Rats following Acoustic Trauma

Zhu

et al. 2017

Front. Neurosci.

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Acoustic trauma is the most common cause of hearing loss and tinnitus in humans. However, the impact of acoustic trauma on system biology is not fully understood. It has been increasingly recognized that tinnitus caused by acoustic trauma is unlikely to be generated by a single pathological source, but rather a complex network of changes involving not only the auditory system but also systems related to memory, emotion and stress. One obvious and significant gap in tinnitus research is a lack of biomarkers that reflect the consequences of this interactive “tinnitus-causing” network. In this study, we made the first attempt to analyse brain metabolic changes in rats following acoustic trauma using metabolomics, as a pilot study prior to directly linking metabolic changes to tinnitus. Metabolites in 12 different brain regions collected from either sham or acoustic trauma animals were profiled using a gas chromatography mass spectrometry (GC/MS)-based metabolomics platform. After deconvolution of mass spectra and identification of the molecules, the metabolomic data were processed using multivariate statistical analysis. Principal component analysis showed that metabolic patterns varied among different brain regions; however, brain regions with similar functions had a similar metabolite composition. Acoustic trauma did not change the metabolite clusters in these regions. When analyzed within each brain region using the orthogonal projection to latent structures discriminant analysis sub-model, 17 molecules showed distinct separation between control and acoustic trauma groups in the auditory cortex, inferior colliculus, superior colliculus, vestibular nucleus complex (VNC), and cerebellum. Further metabolic pathway impact analysis and the enrichment overview with network analysis suggested the primary involvement of amino acid metabolism, including the alanine, aspartate and glutamate metabolic pathways, the arginine and proline metabolic pathways and the purine metabolic pathway. Our results provide the first metabolomics evidence that acoustic trauma can induce changes in multiple metabolic pathways. This pilot study also suggests that the metabolomic approach has the potential to identify acoustic trauma-specific metabolic shifts in future studies where metabolic changes are correlated with the animal's tinnitus status.

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Section: Introductionmentioning

confidence: 99%

Brain Metabolic Changes in Rats following Acoustic Trauma

Zhu

et al. 2017

Front. Neurosci.

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“…Most reports have been directed at small samples involving civilian personnel. Several studies have reported minimal sensorineural hearing loss in blast-exposed individuals [5][6][7][8][9]25]; however, reversible conductive hearing losses have been more consistently identified. The greatest source of information on symptoms immediately following primary blast injury of the ear may be found in civilian literature [26].…”

Section: Introductionmentioning

confidence: 99%

Development of a comprehensive Blast-Related Auditory Injury Database (BRAID)

Joseph¹,

Horton

Clouser

et al. 2016

J Rehabil Res Dev

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Abstract-The Department of Defense Hearing ConservationProgram provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of demographic, audiometric, point of injury, and medical outcome data, with the primary aim of developing a long-standing and integrated capability for the surveillance, assessment, and investigation of blast-related hearing outcomes. Methods used to develop the dataset are described. Encompassing more than 16,500 Navy and Marine Corps personnel, the Blast-Related Auditory Injury Database (BRAID) includes individuals with a blast-related injury and nonblast control subjects. Using baseline and postdeployment hearing threshold data, a retrospective analysis of the cohort revealed that the rate of hearing loss for the injured servicemembers was 39%. The BRAID will be useful for studies that assess hearing patterns following deployment-related injury, such as blast exposures, that facilitate exploration of health outcomes and whether they are predictive of audiometric disposition and that help establish hearing loss prevention strategies and program policies for affected military commands and servicemembers.

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“…It can develop after PBI or SBI with the effect of direct pressure. Therefore, it should be known that inner ear damage could accompany conductive hearing loss in some cases (9). In a recently conducted study, it was hypoth- esized that tympanic membrane perforation that could develop due to explosion could lead to deviations in the pressure wave, and it could form a protective mechanism over the inner ear.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

Aslıer

Ngy

2017

Turk Arch Otorhinolaryngol

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Objective: The aim of this study is to identify the otologic injuries due to handmade explosive-welded blast travma in the law enforcement officers during the combat operations in the curfew security region and to specify the disorders that Otolaryngology and Head Neck Surgery (OHNS) physicians can face during such operations. Methods:Medical records of patients in law enforcement who were initially treated by OHNS physicians of Silopi State Hospital during combat operations, between December 14, 2015 and January 15, 2016 were reviewed. Twenty-five patients with otologic injuries due to blast trauma were included in the study. Trauma characteristics, physical examination findings, and beginning treatments were identified.Results: Primary blast injury (PBI) was identified as the major disorder in all 24 cases. Tinnitus and hearing loss were the most frequent complaints. In physical examination, tympanic membrane perforations were found in four ears of three patients. Oral methylprednisolone in decreasing doses for 10 days was commenced as an initial treatment in patients with PBI. Secondary blast injury presented in the form of soft tissue damage in the auricular helix due to shrapnel pieces in one patient and a minor surgery was performed. Conclusion:Otologic injuries due to blast trauma may often develop during this type of combat operations. Otologic symptoms should be checked, otoscopic examination should be performed, and patients should consult OHNS physicians as soon as possible after trauma.

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Otologic assessment of blast and nonblast injury in returning middle east‐deployed service members

Abstract: Due to its violent nature, blast exposure causes greater neuro-otological manifestations and deserves prompt otologic evaluation.

Cited by 39 publications

References 14 publications

Brain Metabolic Changes in Rats following Acoustic Trauma

Brain Metabolic Changes in Rats following Acoustic Trauma

Development of a comprehensive Blast-Related Auditory Injury Database (BRAID)

Analysis of Otologic Injuries Due to Blast Trauma by Handmade Explosives

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