Clinical Characteristics and Complaints of Patients With Auditory System Damage After Blast Injury

OBJECTIVE. The objective of the study was to determine the features of complaints and clinical presentation in servicemen with sensorineural and combined hearing loss resulting from acoustic trauma sustained under combat conditions. MATERIALS AND METHODS. 98 servicemen with a diagnosis of acoustic trauma (blast injury) sustained under combat conditions were examined. History and complaint collection, endoscopic examination of the external auditory canal and tympanic membrane (Karl Storz endoscopic equipment, Germany), and pure-tone and speech audiometry (AC-40 audiometer, Interacoustics, Denmark) and tympanometry were performed (AТ235Н audiometer, Interacoustics, Denmark). RESULTS. According to the examination results, 37 patients (37.8%) had sensorineural hearing loss, and 61 patients (62.2%) had combined (mixed) hearing loss. Complaints in patients with sensorineural hearing loss were limited to hearing loss predominantly in the high-frequency range, diffuse tinnitus, and the phenomenon of loudness recruitment. In patients with combined hearing loss, the range of complaints additionally included a sensation of ear fullness, autophony, uniform hearing loss across the entire frequency range, and, occasionally, dizziness, pain, and ear discharge. Concomitant psycho-emotional disturbances – sleep disturbance, emotional lability, increased irritability, and rapid fatigability – were observed in 79.6% of patients. Within the structure of the conductive component of combined hearing impairment, tympanic membrane perforation accounted for 82%, while isolated ossicular chain disruption with an intact tympanic membrane accounted for 18%. CONCLUSIONS. Analysis of the features of complaints and clinical presentation in patients with sensorineural and combined hearing loss after acoustic trauma allows the nature of the auditory system lesion to be presumed with high probability already at the stage of the initial interview, which makes it possible to purposefully plan the scope of instrumental examination and to timely determine indications for surgical treatment.