Blast-Related Ear Injuries among U.S. Military Personnel

By Dougherty, Amber L.; MacGregor, Andrew J. et al. | Journal of Rehabilitation Research & Development, June 2013 | Go to article overview

Blast-Related Ear Injuries among U.S. Military Personnel


Dougherty, Amber L., MacGregor, Andrew J., Han, Peggy P., Viirre, Erik, Heltemes, Kevin J., Galarneau, Michael R., Journal of Rehabilitation Research & Development


INTRODUCTION

The increased use of improvised explosive devices (IEDs) by terrorists and insurgent activities in Iraq and Afghanistan has yielded an unprecedented proportion of blast-related casualties compared with previous wars [13], with recent estimates indicating blasts are responsible for approximately 75 percent of U.S. combat casualties in Operations Iraqi and Enduring Freedom [4]. The ear is the most vulnerable and typically the first organ to incur injury from a blast (or pressure) wave [5-7]. Although hearing protection devices are available in the combat theater, recent anecdotal reports indicate some troops decline to wear hearing protection for fear of reduced situational awareness on the battlefield [8-10]. Not surprisingly, blast injury to the ear has emerged among deployed military personnel [11-12].

Blast-related ear injuries often present as damage to the sensitive structures of the inner and middle ear, such as the cochlea, ossicular chain, tympanic membrane (TM), and vestibular system [5,13-14]. Damage to these components of the auditory system may result in transient or permanent impairment, such as hearing loss and tinnitus (ringing in the ears) [15-17]. In 2010, hearing loss and tinnitus were the top two service-connected disabilities among veterans receiving compensation [18], and they are increasing at a dramatic rate [18-20]. From fiscal years 2006 to 2010, the number of veterans who received new compensation awards for "impairment of auditory acuity" grew by more than 72 percent [18]. The total annual expense to deliver hearing healthcare services and compensate veterans for hearing impairment has been estimated to exceed $1 billion [20].

Blast-related ear injuries are a primary concern during deployment because they can compromise an individual's hearing acuity and, as a result, may reduce situational awareness and adversely affect operational readiness [21]. In a communication-dependent environment, such as the battlefield, where listening can be critical for combat effectiveness and survival, a hearing-impaired servicemember may become "more of a liability than an asset" [22]. As such, the prevention, identification, and treatment of blast-related ear injuries are critical to the overall mission and health of the force. The objectives of this study were to (1) assess the prevalence and types of blast-related ear injuries among servicemembers wounded in Operation Iraqi Freedom; (2) examine the effect of hearing protection worn during the blast injury event; and (3) identify the association between specific ear injuries, new-onset hearing loss, and tinnitus outcomes within 1 yr after injury.

METHODS

Study Population

The study population was obtained from the Expeditionary Medical Encounter Database (EMED), which is maintained by the Naval Health Research Center in San Diego, California. The EMED contains information abstracted from medical records of U.S. military personnel completed by providers at forward-deployed Navy-Marine Corps treatment facilities in the combat zone (i.e., nearest to the point of injury) and throughout the continuum of care [23]. Records from each level of care are reviewed by certified nurse coders at the Naval Health Research Center and assigned codes from the International Classification of Diseases-9th Revision-Clinical Modification (ICD-9-CM), Abbreviated Injury Scale (AIS) 2005, and Injury Severity Score (ISS) coding systems [24-26].

At the time of this analysis, there were 13,226 military personnel in the EMED with an injury event that occurred during Operation Iraqi Freedom. Of these, 4,817 were injured in a blast during the study period between March 1, 2004, and August 31, 2008 (Figure). A blast injury event was defined as the presence of a blast-related mechanism of injury and/or ICD-9-CM external cause of injury code (E code) in the EMED clinical record. The blast mechanisms of injury included aerial bomb, grenade, IED, vehicle-borne IED, landmine, mortar, rocket-propelled grenade, rocket, and unexploded ordinance. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Blast-Related Ear Injuries among U.S. Military Personnel
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.