Relationship between hearing loss and body injuries caused by various firearms at a war site: A retrospective study

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BACKGROUND: This study aimed to investigate the relationship between trauma severe enough to cause physical injury and subsequent hearing loss in military personnel exposed to blast events. METHODS: A retrospective review was conducted on 95 patients aged 30-39 who were admitted between 2015 and 2018 due to blast-related injuries and acoustic trauma. A control group of 51 military personnel without complaints was included. Patients were categorized based on the location of trauma, the energy level of the explosion, and the presence of tympanic membrane perforation. Hearing thresholds and clinical characteristics were compared between groups to evaluate the relationship between trauma patterns and auditory outcomes. RESULTS: Patients with head-related injuries had significantly worse air and bone conduction thresholds at multiple frequencies compared to those with injuries in other body regions (p<0.05). Tympanic membrane perforation was significantly associated with eye injuries (p=0.004) and elevated air conduction thresholds (p<0.05), but not with bone conduction thresholds. Exposure to medium and high-energy blasts was associated with elevated hearing thresholds across all frequencies compared to controls (p<0.001). CONCLUSION: Blast-related acoustic trauma is associated with hearing loss across a range of frequencies. Tympanic membrane perforation contributes to air conduction hearing loss. Eye injury may be anatomically related to tympanic membrane damage. Hearing assessment should be integrated into the multidisciplinary care of trauma patients in war zones.