COMBAT EAR INJURY
DOI:
https://doi.org/10.11603/2414-4533.2025.2.15390Keywords:
blast injury, tympanic membrane perforation, hearing restoration treatmentAbstract
The aim of the work: to investigate the anatomical variations of the external auditory canal in patients with traumatic tympanic membrane perforations caused by blast injuries sustained during wartime and to analyze the functional outcomes of reconstructive surgeries performed at different intervals following surgical treatment, depending on the anatomical structure of the ear.
Materials and Methods. A total of 105 patients with central tympanic membrane perforations caused by blast injuries during military operations between 2022 and 2024 were examined. All patients underwent otomicroscopic, otoendoscopic, and audiometric evaluations, as well as computed tomography (CT) of the temporal bones in both axial and coronal projections. Anatomical and functional outcomes of reconstructive surgeries were assessed in both early (6–12 months) and late (12–18 months) postoperative periods. Statistical analysis of the obtained data was conducted using the STATISTICA software.
Results. Among the 105 patients with central tympanic membrane perforations caused by blast injuries, several anatomical variants of the external auditory canal (EAC) were identified based on otomicroscopy and temporal bone CT scans: hourglass-shaped EAC with a prominent anterior wall projecting into the canal (29 patients), conical EAC with narrowing at the level of the bony tympanic ring (20 patients), cylindrical EAC (56 patients). All patients received specialized surgical care in the Ear Microsurgery and Otoneurosurgery Department of the O.S. Kolomiychenko Institute of Otolaryngology, aimed at restoring the anatomical integrity of the tympanic membrane and middle ear structures, as well as improving auditory function. Follow-up observations revealed that the epithelization of the neotympanic membrane typically occurred within 3 - 4 months. Most patients did not exhibit signs of EAC stenosis, and the rate of postoperative complications, such as secondary perforations of the tympanic membrane, was low.
Conclusions. Functional outcomes in terms of hearing restoration were found to be satisfactory across all patient groups and did not depend on the initial anatomical configuration of the external auditory canal.
References
Hurʺyev SO, Kravtsov DI, Ordatiy AV et al. Novi pryntsypy standartyzatsiyi tyazhkosti poshkodzhenʹ u postrazhdalykh iz minnovybukhovoyu ta vohnepalʹnoyu travmoyu v umovakh suchasnykh boyovykh diy [New principles of standardization of the severity of injuries in victims with mine and gunshot trauma in conditions of modern hostilities]. XVII zʺyizd ortopediv – travmatolohiv Ukrayiny: Zbirnyk naukovykh pratsʹ. K. 5–7 zhovtnya 2018; 36-7. DOI: 10.22141/1608-1706.2.19.2018.130648. Ukrainian. DOI: https://doi.org/10.22141/1608-1706.2.19.2018.130648
Zarutsʹkyy YAL, Zaporozhan VM, Bilyy VYA ta in. Voyenno-polʹova khirurhiya : pidruchnyk ; za red. YAL Zarutsʹkoho, VYA Biloho [Military field surgery: textbook; edited by Ya. L. Zarutskyi, V. Ya. Bilyi]. K.:FENIKS. 2018; 93-104, 203-211, 369-401. Ukrainian.
Khomenko IP, Korolʹ SO, Shapovalov VYU, Khoroshun EM. Orhanizatsiya nadannya khirurhichnoyi dopomohy poranenym na rivnyakh medychnoho zabezpechennya pry provedenni Antyterorystychnoyi operatsiyi / Operatsiyi obʺyednanykh syl [Organization of surgical care for the wounded at the levels of medical support during the Anti-Terrorist Operation / Joint Forces Operation]. Viysʹkova medytsyna Ukrayiny. 2019; 4(19):5-15. DOI: 10.32751/2663-0761-2019-04-01. Ukrainian.
Kokkalis ZT, Papanikos E, Mazis GA, Panagopoulos A, Konofaos P. Lateral arm flap: indications and techniques. Eur J Orthop Surg Traumatol. 2019; 2(29):279-84. DOI: 10.1007/s00590-019-02363-0.
Lou Z-C, Zi-Han Lou, Qing-Ping Zhang. Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome [Electronic resource]. American Journal of Otolaryngology. 2012; 33(5):549-55. DOI: https://doi.org/10.1016/j.amjoto.2012.01.010
Shankar K. Sridhara, Arnaldo Rivera, Philip Littlefield Tympanoplasty for blast-induced perforations: the Walter Reed experience [Electronic resource]. Otolaryngology – Head and Neck Surgery. 2012; 148(1):103-07. DOI: 10.1177/0194599812459326. DOI: https://doi.org/10.1177/0194599812459326
Shydlovsʹka TA, Shevtsova TV, Poymanova OS ta in. Stan slukhovoyi funktsiyi za danymy subyektyvnoyi audiometriyi u postrazhdalykh z akutravmoyu, otrymanoyu v zoni provedennya antyterorystychnoyi operatsiyi [State of auditory function according to subjective audiometry data in the victims with acutum trauma obtained in the area of anti-terrorist operation]. Viyskova medytsyna Ukrayiny. 2018; 1:57-65. Ukrainian.
Shin EH, Sabino JM. Ballistic trauma: lessons learned from Іraq and Аfghanistan. Semin Plast Surg. 2015; 29(1): 10-19. DOI: 10.1055/s-0035-1544173. DOI: https://doi.org/10.1055/s-0035-1544173
Kokkalis ZT, Papanikos E, Mazis GA, Panagopoulos A, Konofaos P. Lateral arm flap: indications and techniques. Eur J Orthop Surg Traumatol. 2019; 2(29):279-84. DOI: 10.1007/s00590-019-02363-0. DOI: https://doi.org/10.1007/s00590-019-02363-0
Korshnyak VO, Nasibullin BA. Suchasni pohlyady na mekhanizmy vplyvu vybukhovoyi khvyli na tsentralnu nervovu systemu ta formuvannya nevrolohichnoyi symptomatyky [Modern views on the mechanisms of the influence of the explosive wave on the central nervous system and the formation of neurological symptoms]. Mizhnarodnyy nevrolohichnyy zhurnal. 2016; 6:139-42. Ukrainian.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Т. О. ШЕВЧЕНКО
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
