Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Auditory processing disorder wikipedia , lookup
Auditory system wikipedia , lookup
Evolution of mammalian auditory ossicles wikipedia , lookup
Telecommunications relay service wikipedia , lookup
Hearing aid wikipedia , lookup
Hearing loss wikipedia , lookup
Noise-induced hearing loss wikipedia , lookup
Sensorineural hearing loss wikipedia , lookup
Audiology and hearing health professionals in developed and developing countries wikipedia , lookup
VoIIIOle4 Number 3 Pnyiz 1369 Rnbiolnwwal14l1 Medicalloumnl of [he Fnlll990 Islamic Republie or Iran Original Articles Downloaded from mjiri.iums.ac.ir at 3:45 IRDT on Friday May 5th 2017 HEARING IMPAIRMENT CAUSED BY WAR NEMATOLLAH MOKHTARI AMIRMAJDI, M.D. AND MASSOUD SHARIF!, M.D. Frolll till' Gllat'lt( Medic(11 C,'IIIt'r, Maslwtl Ulli,'crsityof Mt'dictll Scil!/ICl'S, Maslwd, hlamic: Republic of lrall. ABSTRACT 120 cases of Iranian soldiers complaining of hearing loss, were studied over a period of three years at the Ghaem Medical Center in Mashad,Iran. There was adequate information in III cases that their engagement in different types of explosions had caused their hearing impairment. The following aspects were evaluated: 1- Categorization of their hearing impairment. 2- The otoscopic findings. 3- The severity of the hearing impairment, the side of involvement and their relation to the type of explosion. This study while implying that war seems to be a major factor in causing hearing impairment, intends to clarify some of the cause and effect relations also. The hearing impairment caused by war can be of different types and severity and will be a real handicap. The abrupt loud impact noise and blast wave exposure are considered to be causes of hearing impairment. In ourseriesof III cases the different types of sensorineural hearing loss are more common than simple ruptured ear-drums. MJIRI, Vol. 4, No.3, 161-163, 1990 situation in the research worksofYoldrich was created INTRODUCTION stimulating the experimental ears with 145 dB in 3 minutes. Roberto and co-workers7 have made a similar The live weapons, artillery, heavy bombings and explosions are the cause of many lives lost and hand Table 1- Types of hearing impairment in war icapped (rom war all over the world. Hearing impair Typo or hearing 'OSS e.... 'Yo 1 Sensorineural 54 46.7 2 High frequency 31 29 3 Conductive 24 22.4 4 Functional 2 1.9 'II 100% ment is one ofthe ailments resulting from war, and little is written about it. Although researchers have ex perimentally developed similar situations in order to study the subject,·,·7 .• clinical work and reports on JH humans are qUIte . f ew ... Unlike the very gradual and continuous type of damage to the cochlea caused in industrial conditions 1.3 hearing damage due to military activities is secondary to the loud impact noise and blast wave Total exposures appearing in a matter of seconds. A closer 161 Hearing Impairment Caused By War Tahle 11- Otoscopic findinJ.:s l'crrllrulcd eardrum Types ofhcllring TrotulllOIo(nur impairment 1Ji- Uni- latcrul lateral 5 Downloaded from mjiri.iums.ac.ir at 3:45 IRDT on Friday May 5th 2017 ComJuctivt: X Sensorineural 3 High-frequency 2 Functional I c Q " " The i'Cl'crily ofhe:lring ItJ�'" Type of hl'!lrin� § impairment oS ;: UnilOlt(,'fill conductive 3 I 5 14 BilOiteral conductive - 5 - 45 54 Ullilatcral Scnsorineural I I 21-\ 31 - Bilateral Sensorincural 1 1 Uni- !literal lateral 1 " c " Co e ... e e " :t Ul1rclu(\.'d 1lI- Tablc 111- The sc\'crit\' of hearing I()s� --. E ;; Oe�ld car Total experiment on sheep and chenchillas with 160 dB, and '1., an acute mechanical fracture of the organ of Corti was Moderale SC\'()rl' - I Mild .1 1 11 .1 " .' I 11 III 'J 11 1.1 17 17 IH 17 . .1 n.7 .16 14 demonstrated. The damage to the basilar membrane and Hensen cells are part of the histopathology caused Sensorineural hearing loss, High frequency 10ss .This type of sensorineural by the loud impact noise in the experiments of 2 Voldrich Finally if the victim survives the other hearing loss is seperately categorized because of its injuries, acoustically, a precox aged ear with severe handicap will result from these types of traumatic handgun. specific relation to the abrupt loud impact noise of a exposures. Conductive hearing loss, corresponding to rupture of the eardrum or ossicular chain derangement. While our experience in every day clinical work speaks in favor of membrane perforations, rupture of Functional the eardrum, etc" documents pointing to what hap Table I summarizes this categorization. pens in the auditory system of a soldier whose ears are 26 being damaged are scarce. . The clinical history most 4 ly reports of accidental explosions near the firemen The otoscopic findings are summarized in Table 11. The perforated eardrum was considered to be unre and may be quite different from the real military positive history of a previous ear infection. lated to the trauma of war when the soldier had a strong experiences presented in this paper. The therapeutic aspect is only confined to the ruptured eardrum, a The severity of the hearing loss: The degree of the hearing loss was studied in those whose hearing prob lem was sensorineural or conductive. Table II J summa rizes this part of the study. clinical finding which is not the main problem. The sensorineural deafness is the major part of the ailment caused by war as is shown in this presentation. Hearing impairment and its relation to the type of explosion: The history of the type of explosion was asked for and the number of cases was recorded in MATERIAL AND METHOD Table IV. A c1inico-audiological study was designed to include those soldiers who were complaining from hearing Table IV- Heotring impairment relating to the tvpe of expio!'.ioll impairment caused by war. This study was performed TY I.C of Hand�un twenty soldiers were originally brought into this �� Suhm:lchinc prospective study. They were followed for a period of impairment three years. Nine of them were dropped because they Scnsori- at thc ENT out-patient department of the Ghaem Medical Center in Mashad, Iran. One hundred and Type ufhc:tring Cuscs "/" In 411 Ix I" 5.1 Conductive 3 14 Functional I Total 3(1 neural did not have adequate information to confirm their High - hearing impairment was caused by war trauma. The frequency data collected from III cases are summarized as fol lows: Categorization of the hearing impairment: The gun RPC Hcltvy Artillery Cases % 162 Explf)�icms .r, c § ",� 45 (, 15 411 (, 20 .< 17 .1() 4 1.< 15 6.-; 22 I 3H 'tj " W Cu:ocs hearing loss of the troopers were classified in the following four groups: Homb !md Mine 2X 30 3() ;;: 1 " -,- 04 N. Mokhtari Amirjahedi, M.D. and M. Safari, M.D. Perforated eardrum while still a point of interest to RESULTS both the author's and trooper's interest. is just a physical finding more common with the conductive In this study, sensorineural hearing loss was the most common type of hearing impairment and the type of hearing loss. The aim of this paper was to severity of this complication places war trauma as the demonstrate the higher incidence of sensorineural hearing loss . its severity and the handicap caused by foremost factor causing hearing handicaps. war (Tables II. Ill). The abrupt loud impact noise of heavy explosions As far as the type of explosions are concerned there may be possibility of a cause and effect relation be Downloaded from mjiri.iums.ac.ir at 3:45 IRDT on Friday May 5th 2017 and continued handgun shooting as well as the blast wave exposure are considered to be the major factors tween the type of explosions and the type of hearing responsible for producing sensorineural hearing loss. impairment. Thus. the high frequency sensorineural The complications within the auditory system are hearing is mostly caused by handguns and the conduc studied in more detail pointing to the possibility of a cause and effect relation between the type of explo tive hearing loss is the result of bomb and mine sions and the type of hearing impairment. explosions (Table IV). DISCUSSION REFERENCES l. Ward W D: Noise-induceu hearing loss. Otolaryngology. 2nd III cases of hearing impairment caused by war. edition. vol. 2. \V.B. Saunders Co. 19XO. were the subject of this clinico-audiologic assessment 1. Voidrich L. et ill: Comparative method for the study of structural over a period of three years. Adequate history was damngc in acoustic [muma. Laryngoscope. 18R7-IHLJ I. ILJHO. obtained and physical exam performed to verify that 3. Mc Gill T J. et al: Human cochlear changes in noisc-inducr.:d the patient's hearing impairment has resulted from the hearing loss. Laryngoscopr.: 1293-1301. 1970. 4. Merwin G E. et al: Paper patch of blast rupture of thr.: tympanic soldier's engagement in different types of explosions. mr.:mhrane. Laryngoscope oS35. 1980. This limited study while not sufficient to draw a 5. Phillips Y. et al: BiaSI injuries of the ear in militaryopt.!rations. Thr.: statistical conclusion. may be able to comment on the Annals of Otology, Rhinology. Laryngology 1989. Supplement following facts with some degree of certainty: t411. May 19H9. 6. Casler J D. et al: Treatment of the blast injury to the car. Tht.! War is a major source of loud impact noise and will Annals of Otology. Rhinology. Lnrynology 19R9. Supplelllr.:nt increase the incidence of hearing impairment. 140. M,IY 19N9. Consideringof the type of hearing impairment and its 7. Roherto M. et nl: Damagt.! of the auditory systt.!1ll associated with severity. the conclusions drawn from Tables I and II acute blast trauma. The Annals of Otology. Rhinology. Laryn may suggest that 76 of the hearing impairments are gology 19N9. Supplement 140. May 1989. S. Richmond D R. et :II: Physical correliues of eardrum rupture. The classified as sensorineural and 50 of them will either Annals of Otology. Rhinology. Laryngology 19N9. Supplement have a dead ear or severe hearing loss. Thisstudy points 1411. May 19H9. to the significance of war trauma as a major factor causing hearing handicaps. 163