Diagnosis and treatment of combat injuries of the ear

Abstract

The authors discuss specifics of the wound process in modern combat injury of the ear, significance and specifics of diagnosis of gunshot ear injury related to individual characteristics of gunshot wounds with consideration of the accepted anatomical classification of the injured zones. Typical complications of ear injuries are described that can result in death. The authors analyze an approach to surgical treatment of traumatic ear injuries based on their own experience, including non-conventional choice of the type of surgery. They proposed an algorithm to assess the auditory and vestibular analyzers in the injured based on their analysis of date obtained from 772 patients, determine types of pure-tone audiograms typical for acoustic and barotrauma, and underline the informative value of optokinetic nystagmus assessment. Various types of conservative management of the sequelae of the mine-blast ear trauma are discussed aimed at potential minimization of the post-traumatic reactions of the auditory and vestibular analyzers. The authors draw attention to the importance of early treatment, the highest effectiveness of combination therapy and plasmapheresis. They propose their experience of care for the above mentioned traumatic injuries to improve treatment efficacy.

Keywords

• gunshot wounds
• mine-blast trauma
• sensorineural hearing loss
• vestibular dysfunction