Muhammad Riaz Akhtar, Tahir Ahmed, Shahid Pervez.
Otological manifestations of Bomb Blast Injury.
Pak Armed Forces Med J Jan ;52(2):213-8.

The study was conducted to assess the spectrum and pattern of otological injuries in bomb blast. Observational/non-interfering descriptive study of the trauma to the auditory system in a bomb blast in a bus was explored. This study was conducted from 28 to 30 Oct. 2001 in a tertiary care hospital, following a bomb blast in a bus on 28`h October 2001. An explosive charge detonated under a seat in a local urban transport bus on 28th October 2001, killing 3 passengers on the spot. All the survivors who required medical treatment were transferred to a major medical facility located about 100 metres from the scene of the incident. All those, admitted or reporting to ENT Department, were examined for any ear nose or throat injury. In the otological evaluation the audiological and vestibular symptoms were recorded and tuning fork tests, pure tone audiometery and Hallpike manoeuvre were also performed. The otological manifestation of blast trauma were hearing loss, tinnitus, ear discharge and pain. Vertigo was not a symptom of blast trauma. Perforation of tympanic membrane was a common sign in blast trauma. Sensorineural hearing loss was also one feature of bomb blast injury. Typical noise induced deafness was found in 36 % of total ears tested on PTA. The 256 Hz tuning fork was more sensitive in detecting conductive deafness as compared to 512 Hz tuning fork in Rinne test. The results of the study call for the necessity of early ENT observation of all the patients who are subjected to explosive trauma because the ear is particularly susceptible to damage.

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