Blast-induced hearing loss
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The incidence of blast injury has increased recently. As the ear is the organ most sensitive to blast overpressure, the most frequent injuries seen after blast exposure are those affecting the ear. Blast overpressure affecting the ear results in sensorineural hearing loss, which is untreatable and often associated with a decline in the quality of life. Here, we review recent cases of blast-induced hearing dysfunction. The tympanic membrane is particularly sensitive to blast pressure waves, since such waves exert forces mainly at air–tissue interfaces within the body. However, treatment of tympanic membrane perforation caused by blast exposure is more difficult than that caused by other etiologies. Sensorineural hearing dysfunction after blast exposure is caused mainly by stereociliary bundle disruption on the outer hair cells. Also, a reduction in the numbers of synaptic ribbons in the inner hair cells and spiral ganglion cells is associated with hidden hearing loss, which is strongly associated with tinnitus or hyperacusis.
近年来爆震性损伤的发生率逐渐上升。 由于耳朵是对爆炸压力最敏感的器官, 因此它在爆震性损伤中最易受累。 爆炸压力造成的耳朵损害主要是不可逆的感音神经性耳聋, 进而导致生活质量的下降。 我们在本文回顾了近年来爆震性听力损失的一些病例。 鼓膜对爆炸压力波特别敏感, 因为在体内这种压力波主要在空气—组织交界面释放能量。 然而, 由爆炸引起的鼓膜穿孔比其他原因引起的更难以治疗。 爆炸压力能破坏内耳外毛细胞上的纤毛束, 从而引起感音神经性耳聋。 同时, 内毛细胞的神经突触和螺旋节细胞的减少会引起隐性听力损失, 从而引起耳鸣和听觉过敏。
关键词爆震性损害 隐性听力损失 感音神经性耳聋 纤毛 鼓膜穿孔
The author is deeply grateful to Dr. Katsuki NIWA and Dr. Takaomi KURIOKA at National Defense Medical College, Saitama, Japan for their assistance.
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