Hearing loss in mine-blast injuries: pathogenesis and clinical manifestations

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Abstract

Mine-blast injuries (MBI) are a serious medical problem in the context of modern military conflicts and terrorist attacks. The most common and severe complication of MBI is hearing loss, which significantly reduces the quality of life of victims, limiting their communication capabilities, contributing to social isolation, deterioration of cognitive functions and psychological state. Hearing loss in MBI develops as a result of the impact of shock and sound waves on the auditory apparatus, which leads to damage to the structures of the middle and inner ear, as well as the auditory nerve. There are conductive, sensorineural and mixed forms of hearing loss, each of which has its own pathogenesis features and requires specific approaches to diagnosis and treatment. Clinical manifestations vary from acute to chronic forms and are accompanied by varying degrees of hearing loss. Hearing loss resulting from MBI is caused by complex mechanical and pathophysiological processes occurring in the auditory apparatus under the influence of a shock wave. The shock wave, interacting with the tissues of the body, causes mechanical damage that affects the structures of the inner ear and the auditory nerve. Understanding the pathogenesis and clinical manifestations of hearing loss allows to develop effective methods of prevention, diagnosis and treatment, which helps improve the quality of medical care.

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About the authors

V. V. Bedoeva

North Ossetian State Medical Academy

Email: gekhaev_alikhan@mail.ru
ORCID iD: 0009-0000-3575-8784

Postgraduate Student at the Department of Otolaryngology and Ophthalmology

Russian Federation, Vladikavkaz

E. T. Gappoeva

North Ossetian State Medical Academy

Email: gekhaev_alikhan@mail.ru

Dr. Sci. (Med.), Associate Professor, Head of the Department of Otolaryngology and Ophthalmology

Russian Federation, Vladikavkaz

Alikhan U. Gekhaev

Chechen State University named after A.A. Kadyrov; Republican Oncology Dispensary

Author for correspondence.
Email: gekhaev_alikhan@mail.ru
ORCID iD: 0009-0009-8536-1190
SPIN-code: 3125-7758

Cand. Sci. (Med.), Teaching Assistant at the Department of Hospital Surgery, Chechen State University named after A.A. Kadyrov, Head of the Department of Head and Neck Tumors, Republican Oncology Dispensary

Russian Federation, Grozny; Grozny

References

  1. Mizutari K. Blast-induced hearing loss. Journal of Zhejiang University Science. 2019;20(2):111–115. https://doi.org/10.1631/jzus.B1700051
  2. Гурьев С.О., Кравцов Д.И., Казачков В.Е., Ордатий А.В. Минно-взрывная травма вследствие современных боевых действий на примере антитеррористической операции на Востоке Украины. Сообщение 1. Клинико-эпидемиологическая характеристика пострадавших с минно-взрывной травмой на раннем госпитальном этапе оказания медицинской помощи. Травма. 2015;16(6):5–8. [Guryev S.O., Kravtsov D.I., Kazachkov V.E., Ordatiy A.V. Mine-blast injury due to modern combat operations on the example of the anti-terrorist operation in the East of Ukraine. Report 1. Clinical and epidemiological characteristics of victims with mine-blast injury at the early hospital stage of medical care. Travma. 2015;16(6):5–8. (In Russ.)].
  3. Денисов А.В., Хоминец В.В., Логаткин С.М. и др. Разработка шкалы оценки тяжести минно-взрывных ранений защищенных нижних конечностей человека. Вестник Российской военно-медицинской академии. 2021;23(3):195–204. [Denisov A.V., Khominets V.V., Logatkin S.M., et al. Development of a scale for assessing the severity of mine-blast wounds of protected human lower extremities. Vestnik Rossiyskoy voyenno-meditsinskoy akademii. 2021;23(3):195–204. (In Russ.)]. https://doi.org/10.17816/brmma73198
  4. Smith J.E., Garner J. Pathophysiology of primary blast injury. J R Army Med Corps. 2019;165(1):57–62. https://doi.org/10.1136/jramc-2018-001058
  5. Remenschneider A.K., Lookabaugh S., Aliphas A., et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol. 2014;35(10):1825–1834. https://doi.org/10.1097/MAO.0000000000000616
  6. Brokaw E.B., S Brungart D., M Byrne R., et al. Recommendations for a military health system auditory blast injury prevention standard. Military Medicine. 2023;188(Suppl 6):176–184. https://doi.org/10.1093/milmed/usad078
  7. Shukla A., Harper M., Pedersen E., et al. Hearing loss, loneliness, and social isolation: a systematic review. Otolaryngol Head Neck Surg. 2020;162(5):622–633. https://doi.org/10.1177/0194599820910377
  8. Park S.Y., Ho S.H., Hong Y.J., et al. The effect of hearing loss on cognitive function in subjective cognitive decline. Dement Geriatr Cogn Disord. 2022;51(4):348–356. https://doi.org/10.1159/000526230
  9. Kim H.J., Jeong S., Roh K.J., et al. Association between hearing impairment and incident depression: a nationwide follow-up study. The Laryngoscope. 2023;133(11):3144–3151. https://doi.org/10.1002/lary.30654
  10. Cheng Y.-F., Xirasagar S., Yang T.-H., et al. Association of hearing loss with land transport accidents: a nationwide population-based study. Int J Audiol. 2022;61(9):731–735. https://doi.org/10.1080/14992027.2021.1998677.
  11. Плиш Н.Ю., Кривенко С.Н., Медведев Д.И., и др. Результаты лечения пострадавших с минно-взрывными травмами. Вестник неотложной и восстановительной хирургии. 2019;4(3):90–104. [Plish N.Yu., Krivenko S.N., Medvedev D.I., et al. Results of treatment of victims with mine-blast injuries. Vestnik neotlozhnoy i vosstanovitel’noy khirurgii. 2019;4(3):90–104. (In Russ.)].
  12. Глазников Л.А., Буйнов Л.Г., Нигмедзянов Р.А., и др. Состояние микроциркуляции крови в бульбарном отделе конъюнктивы у пострадавших с акубаротравмой слуховой системы. Авиакосмическая и экологическая медицина. 2017;51(2):41–47. [Glaznikov L.A., Buynov L.G., Nigmedzyanov R.A., et al. State of blood microcirculation in the bulbar conjunctiva in victims with acubarotrauma of the auditory system. Aviakosmicheskaya i ekologicheskaya meditsina. 2017;51(2):41–47. (In Russ.)]. https://doi.org/10.21687/0233-528X-2017-51-2-41-46
  13. Paik C.B., Pei M., Oghalai J.S. Review of blast noise and the auditory system. Hearing research. 2022;425:108459. https://doi.org/10.1016/j.heares.2022.108459
  14. Choi C.-H. Mechanisms and treatment of blast induced hearing loss. Korean J Audiol. 2012;16(3):103–107. https://doi.org/10.7874/kja.2012.16.3.103
  15. Тюрин М.В., Озерецковский Л.Б., Денисов А.В. Судебно-медицинские аспекты механогенеза взрывной травмы. Судебно-медицинская экспертиза. 2013;56(3):31–34. [Tyurin M.V., Ozeretskovsky L.B., Denisov A.V. Forensic aspects of the mechanogenesis of blast trauma. Sudebno-meditsinskaya ekspertiza. 2013;56(3):31–34. (In Russ.)].
  16. Гурьев С.Е., Кравцов Д.И., Титова Ю.П. Клинико-патоморфологическая характеристика современных боевых ранений. Травма. 2017;18(5):50–53. [Guryev S.E., Kravtsov D.I., Titova Yu.P. Clinical and pathomorphological characteristics of modern combat wounds. Travma. 2017;18(5):50–53. (In Russ.)]. https://doi.org/10.22141/1608-1706.5.18.2017.114117
  17. Ortega R., Vietor R., Arbelaez C., et al. Blast Injuries. N Engl J Med. 2024;391(23):e58. https://doi.org/10.1056/NEJMvcm2408353
  18. Hazell G.A., Pearce A.P., Hepper A.E., Bull A.M.J. Injury scoring systems for blast injuries: a narrative review. Br J Anaesth. 2022;128(2):e127–e134. https://doi.org/10.1016/j.bja.2021.10.007
  19. Michels T.C., Duffy M.T., Rogers D.J. Hearing loss in adults: differential diagnosis and treatment. Am Fam Physician. 2019;100(2):98–108.
  20. Joseph A.R., Shaw J.L., Clouser M.C., et al. Impact of blast injury on hearing in a screened male military population. Am J Epidemiol. 2018;187(1):7–15. https://doi.org/10.1093/aje/kwx199
  21. Dougherty A.L., MacGregor A.J., Han P.P., et al. Blast-related ear injuries among U.S. military personnel. J Rehabil Res Dev. 2013;50(6):893–904. https://doi.org/10.1682/JRRD.2012.02.0024
  22. Королева К.Ю., Савченко И.Ф., Миронов В.Г., Лемешкин Р.Н. Особенности поражения органа слуха при минно-взрывной травме в военных конфликтах. Известия Российской военно-медицинской академии. 2020;39(S4):293–296. [Koroleva K.Yu., Savchenko I.F., Mironov V.G., Lemeshkin R.N. Features of damage to the hearing organ in mine-blast injury in military conflicts. Izvestiya Rossiyskoy voyenno-meditsinskoy akademii. 2020;39(S4):293–296. (In Russ.)].
  23. Горохов А.А., Миронов В.Г., Касаткин А.Н., и др. Оториноларингологические контузии при минно-взрывной травме. Вестник Российской военно-медицинской академии. 2021;23(2):53–58. [Gorokhov A.A., Mironov V.G., Kasatkin A.N., et al. Otorhinolaryngological contusions in mine-blast injury. Vestnik Rossiyskoy vo-yenno-meditsinskoy akademii. 2021;23(2):53–58. (In Russ.)]. https://doi.org/10.17816/brmma71305
  24. Ballivet de Régloix S., Crambert A., Maurin O., et al. Blast injury of the ear by massive explosion: a review of 41 cases. J R Army Med Corps. 2017;163(5):333–338. https://doi.org/10.1136/jramc-2016-000733
  25. Cho S.-I., Gao S.S., Xia A., et al. Mechanisms of hearing loss after blast injury to the ear. PloS One. 2013;8(7):e67618. https://doi.org/10.1371/journal.pone.0067618
  26. Янов Ю.К., Гофман В.Р., Глазников Л.А., Максимова Т.Г. Клинико-статистические закономерности поражений слуховой системы при минно-взрывной травме. Военно-медицинский журнал. 2001;322(9):32–37. [Yanov Yu.K., Goffman V.R., Glaznikov L.A., Maksimova T.G. Clinical and statistical patterns of damage to the auditory system in mine-blast injury. Voyenno-meditsinskiy zhurnal. 2001;322(9):32–37. (In Russ.)].
  27. Taşlı H., Gökgöz M.C., Çoban V.K., et al. Does tympanic membrane perforation have a protective effect on the inner ear in blast-injured patients? Ulus Travma Acil Cerrahi Derg. 2021;27(1):79–84. https://doi.org/10.14744/tjtes.2020.87639
  28. Ashworth E., Baxter D., Gibb I., et al. Injuries in underbody blast fatalities: identification of five distinct mechanisms of head injury. J Neurotrauma. 2023;40(1–2):141–147. https://doi.org/10.1089/neu.2021.0400
  29. Littlefield P.D., Brungart D.S. Long-term sensorineural hearing loss in patients with blast-induced tympanic membrane perforations. Ear Hear. 2020;41(1):165–172. https://doi.org/10.1097/AUD.0000000000000751
  30. Nonaka M., Taylor W.W., Bukalo O., et al. Behavioral and myelin-related abnormalities after blast-induced mild traumatic brain injury in mice. J Neurotrauma. 2021;38(11):1551–1571. https://doi.org/10.1089/neu.2020.7254
  31. Wang Y., Ye Z., Hu X., et al. Morphological changes of the neural cells after blast injury of spinal cord and neuroprotective effects of sodium beta-aescinate in rabbits. Injury. 2010;41(7):707–716. https://doi.org/10.1016/j.injury.2009.12.003
  32. Янов Ю.К., Кузнецов М.С., Глазников Л.А., и др. Нарушения коркового отдела слухового анализатора при взрывной травме. Вестник оториноларингологии. 2022;87(1):14–20. [Yanov Yu.K., Kuznetsov M.S., Glaznikov L.A., et al. Disorders of the cortical section of the auditory analyzer in blast injury. Vestnik otorinolaringologii. 2022;87(1):14–20. (In Russ.)]. https://doi.org/10.17116/otorino20228701114
  33. Tripathi P., Deshmukh P. Sudden sensorineural hearing loss: a review. Cureus. 2022;14(9):e29458. https://doi.org/10.7759/cureus.29458
  34. Тарасова Г.Д., Герцен А.В., Джанумова Г.М. Обоснование функциональной классификации тугоухости. Лечащий врач. 2019;(10):11–16. [Tarasova G.D., Gertsen A.V., Dzhanumova G.M. Justification for the functional classification of hearing loss. Lechashchiy vrach. 2019;(10):11–16. (In Russ.)]. https://doi.org/10.26295/0S.2019.76.80.002
  35. Le T.N., Straatman L.V., Lea J., Westerberg B. Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options. J Otolaryngol Head Neck Surg. 2017;46(1):41. https://doi.org/10.1186/s40463-017-0219-x
  36. Olusanya B.O., Davis A.C., Hoffman H.J. Hearing loss grades and the International classification of functioning, disability and health. Bull World Health Organ. 2019;97(10):725–728. https://doi.org/10.2471/BLT.19.230367
  37. Kulinski D., Carr W., Garfield B.A., et al. Acute hearing deficits associated with weapons exposure in section 734 blast overpressure study (BOS). Military Medicine. 2023;188(Suppl 6):666–673. https://doi.org/10.1093/milmed/usad299
  38. Cave K.M., Cornish E.M., Chandler D.W. Blast injury of the ear: clinical update from the global war on terror. Military Medicine. 2007;172(7):726–730. https://doi.org/10.7205/milmed.172.7.726
  39. Павлов В.В., Кичкина М.М., Теплов А.В. Повреждение органа слуха при взрывной шахтовой травме. Медицина в Кузбассе. 2014;13(1):52–55. [Pavlov V.V., Kichkina M.M., Teplov A.V. Damage to the hearing organ in explosive mine injury. Meditsina v Kuzbasse. 2014;13(1):52–55. (In Russ.)].
  40. Akin F.W., Murnane O.D., Hall C.D., Riska K.M. Vestibular consequences of mild traumatic brain injury and blast exposure: a review. Brain Injury. 2017;31(9):1188–1194. https://doi.org/10.1080/02699052.2017.1288928
  41. Lien S., Dickman J.D. Vestibular injury after low-intensity blast exposure. Front Neurol. 2018;9:297. https://doi.org/10.3389/fneur.2018.00297

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2. Figure. Classification of mine-explosive injuries [17]

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