Otologic consequences of blast exposure: a finnish case study of a shopping mall bomb explosion

Mrena, Roderik; Pääkkönen, Rauno; Bäck, Leif; Pirvola, Ulla; Ylikoski, Jukka

doi:10.1080/00016480310017045

Cited by 63 publications

(65 citation statements)

References 8 publications

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“…This damage is primarily mechanical, as the force of the blast wave tears the sensory cells and displaces the basilar membrane. Otologic injury is usually present at the time of the blast, producing temporary or permanent hearing loss and/or tinnitus [20]. Typically, sustained high-intensity noise causes more sensorineural damage than a single, very high-intensity blast [18].…”

Section: Inner Ear Injury: Cochlear Injurymentioning

confidence: 99%

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Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

Fausti¹,

Wilmington²,

Gallun³

et al. 2009

JRRD

187

117

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Abstract-The dramatic escalation of blast exposure in military deployments has created an unprecedented amount of traumatic brain injury (TBI) and associated auditory impairment. Auditory dysfunction has become the most prevalent individual service-connected disability, with compensation totaling more than 1 billion dollars annually. Impairment due to blast can include peripheral hearing loss, central auditory processing deficits, vestibular impairment, and tinnitus. These deficits are particularly challenging in the TBI population, as symptoms can be mistaken for posttraumatic stress disorder, mentalhealth issues, and cognitive deficits. In addition, comorbid factors such as attention, cognition, neuronal loss, noise toxicity, etc., can confound assessment, causing misdiagnosis. Furthermore, some auditory impairments, such as sensorineural hearing loss, will continue to progress with age, unlike many other injuries. In the TBI population, significant clinical challenges are the accurate differentiation of auditory and vestibular impairments from multiple, many times overlapping, symptoms and the development of multidisciplinary rehabilitation strategies to improve treatment outcomes and quality of life for these patients.

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Section: Inner Ear Injury: Cochlear Injurymentioning

confidence: 99%

“…Blast exposure most commonly results in pure SNHL, with a 35 to 100 percent incidence rate in blastinjured patients [2,19,20,[22][23][24]. Of blast-injured soldiers treated at Walter Reed Army Medical Center in 2005, 64 percent had ongoing hearing loss [5].…”

Section: Inner Ear Injury: Cochlear Injurymentioning

confidence: 99%

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

Fausti¹,

Wilmington²,

Gallun³

et al. 2009

JRRD

187

117

View full text Add to dashboard Cite

show abstract

“…They attributed this higher rate to the fact that their data were extracted from an audiology clinic database. Mrena et al assessed the otologic and audiologic outcomes of 29 patients treated for ear injury after a Finland shopping mall explosion [27]. They found that 66 percent reported tinnitus as their initial symptom, and 55 percent reported hearing loss.…”

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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“…Among the many forms of acoustic exposures, blast, a high-energy impulse noise, has received significant attention lately due to the large number of injured soldiers who were involved in recent war operations in Iraq and Afghanistan. Blast can induce a wide range of pathologies in the body, including auditory pathology such as tinnitus and hearing loss, as well as traumatic brain injury (TBI; Breeze et al, 2011;Dougherty et al, 2011;Fausti et al, 2009;Lew et al, 2009;Mrena et al, 2004aMrena et al, ,2002Okie, 2005). Ear injuries constitute the single most frequent injury type sustained in the Iraq War (Gondusky and Reiter, 2005).…”

Section: Introductionmentioning

confidence: 99%

Blast-Induced Tinnitus and Hearing Loss in Rats: Behavioral and Imaging Assays

Mao

Pace

Pierozynski

et al. 2012

Journal of Neurotrauma

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The current study used a rat model to investigate the underlying mechanisms of blast-induced tinnitus, hearing loss, and associated traumatic brain injury (TBI). Seven rats were used to evaluate behavioral evidence of tinnitus and hearing loss, and TBI using magnetic resonance imaging following a single 10-msec blast at 14 psi or 194 dB sound pressure level (SPL). The results demonstrated that the blast exposure induced early onset of tinnitus and central hearing impairment at a broad frequency range. The induced tinnitus and central hearing impairment tended to shift towards high frequencies over time. Hearing threshold measured with auditory brainstem responses also showed an immediate elevation followed by recovery on day 14, coinciding with behaviorally-measured results. Diffusion tensor magnetic resonance imaging results demonstrated significant damage and compensatory plastic changes to certain auditory brain regions, with the majority of changes occurring in the inferior colliculus and medial geniculate body. No significant microstructural changes found in the corpus callosum indicates that the currently adopted blast exposure mainly exerts effects through the auditory pathways rather than through direct impact onto the brain parenchyma. The results showed that this animal model is appropriate for investigation of the mechanisms underlying blast-induced tinnitus, hearing loss, and related TBI. Continued investigation along these lines will help identify pathology with injury/recovery patterns, aiding development of effective treatment strategies.

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Otologic consequences of blast exposure: a finnish case study of a shopping mall bomb explosion

Cited by 63 publications

References 8 publications

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

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

Blast-Induced Tinnitus and Hearing Loss in Rats: Behavioral and Imaging Assays

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