{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:32:23Z","timestamp":1784683943744,"version":"3.55.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Objective:<\/jats:title>\n To describe characteristics of sensorineural hearing loss (SNHL) in patients with blast-induced tympanic membrane (TM) perforations that required surgery.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n A retrospective review of hearing outcomes in those who had tympanoplasty for combat blast-induced TM perforations. These were sequential cases from one military otolaryngologist from 2007 to 2012. A total of 87 patients were reviewed, and of those, 49 who had appropriate preinjury, preoperative, and long-term audiograms were included. Those with pre-existing hearing loss were excluded. Preinjury audiograms were used to assess how sensorineural thresholds changed in the ruptured ears, and in the contralateral ear in those with unilateral perforations.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean time from injury to the final postoperative audiogram was 522 days. In the ears with TM perforations, 70% had SNHLs of 10 dB or less (by bone conduction pure tone averages). Meanwhile, approximately 8% had threshold shifts >30 dB, averaging 50 dB. The strongest predictor of severe or profound hearing loss was ossicular discontinuity. Thresholds also correlated with bilateral injury and perforation size. In those with unilateral perforations, the SNHL was almost always larger on the side with the perforation. Those with SNHL often had a low-to-mid frequency threshold shift and, in general, audiograms that were flatter across frequencies than those of a typical population of military personnel with similar levels of overall hearing loss.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n There is a bimodal distribution of hearing loss in those who experience a blast exposure severe enough to perforate at least one TM. Most ears recover close to their preinjury thresholds, but a minority experience much larger sensorineural threshold shifts. Blast exposed ears also tend to have a flatter audiogram than most service members with similar levels of hearing loss.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/aud.0000000000000751","type":"journal-article","created":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T23:24:52Z","timestamp":1562023492000},"page":"165-172","source":"Crossref","is-referenced-by-count":14,"title":["Long-Term Sensorineural Hearing Loss in Patients With Blast-Induced Tympanic Membrane Perforations"],"prefix":"10.1097","volume":"41","author":[{"given":"Philip D.","family":"Littlefield","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Walter Reed National Military Medical Center, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Brungart","sequence":"additional","affiliation":[{"name":"Department of Audiology, Walter Reed National Military Medical Center, Bethesda, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,1]]},"reference":[{"key":"R1-20230726","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1017\/S0022215110002215","article-title":"Ear injuries sustained by British service personnel subjected to blast trauma.","volume":"125","author":"Breeze","year":"2011","journal-title":"J Laryngol Otol"},{"key":"R2-20230726","first-page":"81","article-title":"Effects of blast overpressure on the ear: Case reports.","volume":"8","author":"Chandler","year":"1997","journal-title":"J Am Acad Audiol"},{"key":"R3-20230726","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1682\/JRRD.2012.03.0038","article-title":"Performance on tests of central auditory processing by individuals exposed to high-intensity blasts.","volume":"49","author":"Gallun","year":"2012","journal-title":"J Rehabil Res Dev"},{"key":"R5-20230726","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1017\/S0022215100128555","article-title":"Blast injury of the auditory system: a review of the mechanisms and pathology.","volume":"108","author":"Garth","year":"1994","journal-title":"J Laryngol Otol"},{"key":"R6-20230726","doi-asserted-by":"crossref","first-page":"465","DOI":"10.3389\/fnins.2017.00465","article-title":"Hidden hearing loss? No effect of common recreational noise exposure on cochlear nerve response amplitude in humans.","volume":"11","author":"Grinn","year":"2017","journal-title":"Front Neurosci"},{"key":"R7-20230726","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.heares.2018.03.008","article-title":"Impaired speech perception in noise with a normal audiogram: No evidence for cochlear synaptopathy and no relation to lifetime noise exposure.","volume":"364","author":"Guest","year":"2018","journal-title":"Hear Res"},{"key":"R8-20230726","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1177\/0194599812458401","article-title":"A new standardized format for reporting hearing outcome in clinical trials.","volume":"147","author":"Gurgel","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R10-20230726","doi-asserted-by":"crossref","DOI":"10.1177\/0194599817717486","article-title":"Tympanoplasty following blast injury.","author":"Keller","year":"2017","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R11-20230726","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/AUD.0000000000000517","article-title":"Effect of blast injury on auditory localization in military service members.","volume":"39","author":"Kubli","year":"2018","journal-title":"Ear Hear"},{"key":"R12-20230726","doi-asserted-by":"crossref","first-page":"14077","DOI":"10.1523\/JNEUROSCI.2845-09.2009","article-title":"Adding insult to injury: Cochlear nerve degeneration after \u201ctemporary\u201d noise-induced hearing loss.","volume":"29","author":"Kujawa","year":"2009","journal-title":"J Neurosci"},{"key":"R13-20230726","doi-asserted-by":"crossref","first-page":"e0162726","DOI":"10.1371\/journal.pone.0162726","article-title":"Toward a differential diagnosis of hidden hearing loss in humans.","volume":"11","author":"Liberman","year":"2016","journal-title":"PLoS One"},{"key":"R15-20230726","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1136\/bmj.325.7372.1117","article-title":"Weber\u2019s test demystified. Physics renders Weber\u2019s test not so mysterious.","volume":"325","author":"Mbubaegbu","year":"2002","journal-title":"BMJ"},{"key":"R16-20230726","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1515\/JBCPP.2008.19.3-4.185","article-title":"Otologic and audiologic lesions due to blast injury.","volume":"19","author":"Nageris","year":"2008","journal-title":"J Basic Clin Physiol Pharmacol"},{"key":"R17-20230726","doi-asserted-by":"crossref","first-page":"e1645","DOI":"10.7205\/MILMED-D-15-00463","article-title":"Traumatic hearing loss in the context of blast-related tympanic membrane perforation.","volume":"182","author":"Pusz","year":"2017","journal-title":"Mil Med"},{"key":"R18-20230726","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1177\/0194599811411143","article-title":"Tympanic membrane rupture in the survivors of the July 7, 2005, London bombings.","volume":"145","author":"Radford","year":"2011","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R19-20230726","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1097\/MAO.0000000000000616","article-title":"Otologic outcomes after blast injury: The Boston marathon experience.","volume":"35","author":"Remenschneider","year":"2014","journal-title":"Otol Neurotol"},{"issue":"2 Suppl","key":"R20-20230726","first-page":"S174","article-title":"Tympanic membrane perforation and hearing loss from blast overpressure in Operation Enduring Freedom and Operation Iraqi Freedom wounded.","volume":"64","author":"Ritenour","year":"2008","journal-title":"J Trauma"},{"key":"R21-20230726","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/j.1749-4486.2008.01823.x","article-title":"Hyaluronic acid fat graft myringoplasty: How we do it.","volume":"33","author":"Saliba","year":"2008","journal-title":"Clin Otolaryngol"},{"key":"R22-20230726","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1682\/JRRD.2014.11.0275","article-title":"Auditory difficulties in blast-exposed Veterans with clinically normal hearing.","volume":"52","author":"Saunders","year":"2015","journal-title":"J Rehabil Res Dev"},{"key":"R23-20230726","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1002\/lary.24169","article-title":"Otologic assessment of blast and nonblast injury in returning Middle East-deployed service members.","volume":"124","author":"Shah","year":"2014","journal-title":"Laryngoscope"},{"key":"R24-20230726","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/0194599816677693","article-title":"Tympanoplasty outcomes for blast-induced perforations from Iraq and Afghanistan.","volume":"156","author":"Song","year":"2017","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R25-20230726","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1177\/0194599812459326","article-title":"Tympanoplasty for blast-induced perforations: The Walter Reed experience.","volume":"148","author":"Sridhara","year":"2013","journal-title":"Otolaryngol Head Neck Surg"}],"container-title":["Ear & Hearing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00003446-202001000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T08:39:25Z","timestamp":1690360765000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00003446-202001000-00017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,28]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/aud.0000000000000751","relation":{},"ISSN":["0196-0202"],"issn-type":[{"value":"0196-0202","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,28]]}}}