Background: Sudden sensorineural hearing loss (SSNHL) from blast trauma in both military and civilian settings can have profound lasting impact on quality of life. SSNHL is the most common form of hearing loss from blast trauma, followed by a mixed conductive loss. This poster aims to highlight the current evidence on early treatment options to optimise patient outcomes. A review of literature was conducted on May 2024 of PubMed, EMBase. A total of 8 studies (observational and case series) are included.
Results: Blast injuries of the ear should be suspected based on functional symptoms and history; a normal otoscopic examination should not be used to rule out significant injury and is an unreliable clinical sign. Presence of bilateral tympanic membrane injury, or perforation size may correlate with threshold of decibel (dB) loss. Urgent referral to pure-tone audiometry and early management are essential. Trauma specialists should initiate oral steroids, with early (<24h after injury) and high dose steroids (prednisone 60mg daily for 7 days) associated with the best audiometric outcomes. Further advanced treatments can be offered with timely referral to a specialist centre. Hyperbaric oxygen therapy within 5 days has shown to improve hearing thresholds after. Intratympanic dexamethasone injections has not been trialled in blast-induced hearing loss, but expert opinion suggests this may have effect. If the hearing impairment persists beyond sub-acute phase, it is often permanent.
Conclusion: Management of SSNHL from blast injuries is uniquely challenging though timely intervention in the acute phase is essential to optimise hearing outcomes.