Acute and chronic management of otologic blast injury

Introduction

In 2005, the Department of Veterans Affairs awarded more than $1 billion for otologic-related disabilities—the majority of which were due to impulse noise exposures and blast injuries. The ear is the body's most sensitive pressure transducer, and as a result, otologic complaints are common after blasts. Fortunately, blast trauma is a rare occurrence in the United States. As a result, much of the civilian literature is drawn from the Boston Marathon bombings, Afghanistan War, and Iraq War. Unique to blast-related otologic trauma, acute management is often dictated by the tactical situation at hand and by the severity of other injuries. In this chapter, we will review evaluation and management patients exposed to otologic blast injuries based on military and civilian experiences as well as animal studies ( Table 5.1 ).

Otologic blast injuries