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Brooke Thall
Dr. Riley
Foundations of College Writing
May 8, 2013
Hearing Loss from Explosions
After a bombing or explosion a person’s hearing is never priority. There is
usually many other severe even life threatening wounds that take precedence.
However, after the initial panic and once things begin to settle down and a full
health checkup takes place, doctors will many times discover that their patient has
hearing loss. The hearing loss may be temporary or permanent but either way it can
have a huge effect on the person’s life. Hearing loss is one of the most common and
also one of the least focused on injuries that often effect bomb victims.
After a bombing when a patient goes to receive medical care, the doctor’s first
priority is usually any life threatening injuries that have occurred. Once the patient
is in a more stable condition they move on to a more overall checkup. It is usually
during this process that they realize that the person has hearing loss. There are
many different signs that the patient has acquired hearing loss. The person can
outright lose hearing in one or both of his or hers ears, or all noises may just seem
muffled to the person. Also his or hers ears may become very sensitive to back
ground noises. Hearing loss can be very evident in a patient. Many times they
cannot understand the questions you are trying to ask them.
Hearing loss can usually be easily identified after a bombing. The
patient may feel like his ears are clogged, that everything is muffled, or may have a
ringing in his ears. Also his ears will be very sensitive and any kind of noise may
hurt his ears. The patient may be talking very loudly because he cannot tell what
volume they are speaking at. If he doesn’t have these obvious signs of hearing loss
an audiologist may still do a hearing test on him.
Hearing loss can affect people in many different ways depending on
what type of hearing loss and how severe it is. When people are near to an explosion
such as with the bombing at the Boston
Marathon hospitals often find that
many of the people that were closest to
the explosion are now dealing with
hearing loss. The two more common
forms of hearing loss that the victims
are dealing with are acoustic trauma
that causes conductive hearing loss
Figure 1 source: American Tinnitus Association 2008
and sensorineural hearing loss. With
the acoustic trauma the delicate ear drum may rupture. With only acoustic trauma
the eardrum will most likely heal within a few weeks or months. However, if the
eardrum does not repair itself the torn can be repaired with an outpatient surgical
reconstruction called a tympanoplasy. (Louis)
Conductive and sensory hearing loss have very different effects on the
patient. The ear is a very complex and sensitive system. The auricle, external
auditory canal, tympanic membrane, and ossicular chain all work together to
localize, amplify, and transmit sound to the cochlea. Usually a person with
sensorineural hearing loss has a genetic deposition to it while a person with a
conductive hearing loss usually has some kind of infection or acoustic trauma to the
ear drum.
Many soldiers who come back from war have some form of hearing loss.
Hearing loss is in veterans is one of the most prevalent disabilities. As seen in
Figure 1 ear plugs are recommended for volumes 85 decibels or above, yet tanks,
Chinook helicopters and grenades have higher decibels than that. Saunders and
Griest (2009) from the National Center for Rehabilitative Auditory Research state
that,
” There are currently 444,583 veterans receiving compensation for
defective hearing and 395,324 receiving compensation for tinnitus. [4]
It is estimated that there are almost one million more veterans with
service-connected hearing loss and/or tinnitus who do not meet the
criteria for receiving compensation. The cost of compensation for
hearing and tinnitus-related disabilities in fiscal year (FY) 2006 was
over USD 1.2 billion.”
Hearing loss in soldiers is caused
by combat and working in
industrial places such as ship
building yards and aircraft
maintenance. Dr. Henry Lew
conducted a study of a group of 66
Iraq War soldier. Thirty eight of
these soldiers were injured and treated and
Figure 2Source The Hearing Journal
2009
after 2 years of recovery the most common long term symptom that the soldiers had
was hearing loss. (Tun, Hogan, Fitzharris 2009) As shown in figure 2 tympanic
membrane, cochlear or vestibular rupture is one of the primary injuries for soldiers.
Hearing loss is a very troubling injury and can be very unpredictable. There
are some treatments for it though none are proven. As stated by Benjamin E
Schreiber, MRCPa, Charlotte Agrup, PhDb, Prof Dorian O Haskard, FMedScic, and
Prof Linda M Luxon, FRCPd (2010), “Many treatments are used, including
corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments.
Although no treatment is proven, we recommend a short course of oral high-dose
corticosteroids. There is much to learn about pathogenesis of sudden sensorineural
hearing loss, and more clinical trials are needed to establish evidence-based
management.” However in cases such as explosions hearing loss has a much higher
chance of being permanent than with sudden sensorneueral hearing loss. If the
hearing loss has not gotten better or disappeared in a few weeks or months then the
person may decide to wear a hearing aide to facilitate in his or hers hearing.
Hearing aides can be expensive and not all insurance companies will pay for them.
In this case many people may just have to live with their reduced hearing.
References
Louis , C. (2013, April 24). Subtler harm from barms: Some victims lose hearing . Retrieved from
http://www.nytimes.com/2013/04/25/us/boston-bomb-victims-hidden-injury-hearingloss.html?_r=0
Saunders, G., & Griest , S. (2009). Hearing loss in veterans and the need for hearing loss
prevention programs. Noise Health , 11(42), 14-21. Retrieved from
http://www.noiseandhealth.org/article.asp?issn=14631741;year=2009;volume=11;issue=42;spage=14;epage=21;aulast=Saunders
Schreiber , B., Agrup, C., Haskard , D., & Luxon , L. (2010). Sudden sensorineural hearing loss.
THE LANCET, 375(9721), 1203-1211. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0140673609620717
Tun , C., Hogan , A., & Fitzharris, K. (2009). Hearing and vestibular dysfunction caused by-blast
injuries and traumatic brain injuries. The Hearing Journal , 62(11), doi:
10.1097/01.HJ.0000364272.60094.e6