Blast Injury of the Ears: The Experience from Yala Hospital, Southern Thailand
Sunee Tungsinmunkong MD*, Cheerasook Chongkolwatana MD**, Wattana Piyawongvisal MD*, Suvajana Atipas MD**, Somporn Namchareonchaisuk BS**
Affiliation : * Otolaryngology unit, Yala Provincial Hospital, Yala ** Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Objective : To report acute and subacute consequences of blast injury to the ear from terrorists’ bombings
experienced from Yala Provincial Hospital, Southern Thailand.
Study
Design : Retrospective chart review was done on 54 patients who suffered otologic injuries from bombing
attacks in Yala Province from January to May 2005. Only 33 patients who had complete otologic and audiologic
examination with a 3-month follow-up were studied.
Materials and Methods : The ear symptoms, the size of tympanic membrane perforation, degree of hearing loss at
first examination within 30 days after injuries were recorded. After a 3-month follow-up, the rate of spontaneous
healing, rate of operation needed and long-term complications including hearing loss were analyzed.
Results : The two most common initial symptoms were hearing loss (72.73%) and tinnitus (66.67%). Tympanic
membrane perforations were encountered in 31 ears of 22 out of 33 patients. Spontaneous healing occurred
in 23 ears (74.19%) with the highest incidence in small perforations (size < 50%). All healings occurred
within 8 weeks. Tympanoplasty was done on the rest, except one patient. Eight patients (24.24%) had senso-
rineural hearing loss without tympanic membrane perforation. They still have sensorineural hearing loss,
which is rather mild and typically affects in high tone with five of this group having normal hearing in speech
range. Eleven patients from the tympanic membrane perforation group still have mixed hearing loss, which
were also mostly mild.
Conclusion : Patients with aural symptoms after a blast injury need thorough otologic and audiological
examination. The spontaneous healing of tympanic membrane perforation from explosive injury was relatively
high (74.19%) after an 8-week follow-up, only 8/31 ears required surgical repair. At 3-months follow-up, more
than two-thirds of the patients still had residual hearing loss, which was rather mild and affected mainly in
high tone.
Keywords : Blast injury, Tympanic membrane perforation, Hearing loss
