FEATURES OF THE MIDDLE EAR DAMAGES AFTER EXPLOSIVE WAR-TIME INJURY AND THEIR MANAGEMENT DURING HIGH SPECIALISED MEDICAL CARE
DOI:
https://doi.org/10.11603/2414-4533.2024.2.14635Keywords:
blast injuries, tympanic membrane perforation, ossicles, hearing loss, tympanoplastyAbstract
The aim of the work: to improve the effectiveness of the diagnosis and treatment the patients with traumatic tympanic membrane perforations caused by blast military wartime injuries. This study evaluated on the injury’s origins, the clinical and diagnostic features, tympanoplasty indications, and results of treatment.
Materials and Methods. A multifactor methodology was adopted to accomplish the current study objective, using theoretical (analytical, comparative, and systematic review of medical literature data), empirical (research analysis on hearing function in follow-up; patient surveys to determine blast injuries origin and damage influence to the middle and inner ear; medical history analysis; otomicroscopic, otoendoscopic, and audiometric data, objective assessment of the Eustachian tube's equi-pressure function and follow-up monitoring of new tympanic membrane graft status and auditory function), and statistical (mathematical processing and interpretation of the empirical data gathered).
72 male patients with different localizations of traumatic tympanic membrane perforation after acoustic and blast injury trauma in active combat zones were included in this study (aged 19 to 54 y.o.). All patients were treated in the Ear Microsurgery and Otoneurosurgery Department of the O.S. Kolomiychenko Institute of Otolaryngology (Kyiv, Ukraine).
Results and Discussion. A high prevalence of middle and inner ear injuries among military personnel were determined after explosive trauma during the military action damage on the battlefield from March to September 2022 during the current russian-Ukrainian war. Different types of tympanoplasty were performed to these patients. No additional inner ear damages were found in follow-up (3-6 months after tympanoplasty) (BC thresholds remained unchanged after surgery); a statistically significant AC thresholds improvement was noted with an average gain of 22.6±2.7 dB and extremely ABG decreasing.
Due to the polytraumatic nature of wartime blast injuries, the extension of advanced diagnostic modalities and the early surgical approaches, even simultaneous septoplasty and tympanoplasty with ossicular chain reconstruction, are reducing the terms of recovery with hearing function improvement. It should increase the urgent medical care standard possibilities of modern wartime injury victims and will allow to restore the combat capability of the military contingent in a short period of time.
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