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Pattern of Hearing Loss from Otological Trauma due to Non-Explosive Blast Injury Caused by Slap to the Ear in Kashmiri Population

Ayaz Rehman ,Sajad Hamid *,Mushtaq Sangoo ,Mymoona Akhter ,Shahnawaz Hamid

The aim of this study is to determine the pattern of hearing loss in otological trauma due to non-explosive trauma caused by slap in Kashmiri population. The study was conducted in otolaryngology clinic of a referral and a teaching tertiary care hospital Sher-i-Kashmir Institute of Medical Sciences Medical College, Bemina, Srinagar, Jammu and Kashmir, where 569 cases with non-explosive blast injury of the ear due to slap, gathered over a 3-year period, is presented. 522 Patients fulfill the inclusion criteria and 47 cases were excluded. All the selected cases underwent otological examination by clinical examination followed by otoscopic examination, PTA (Pure Tone Audiometry) and Impedance audiometry as required. Tympanic membrane perforation was identified and hearing loss was recorded. The frequency of CHL (Conductive Hearing Loss) and MHL (Mixed Hearing Loss) has been found to be 415 cases (79.5%) and 107 cases (20.5%) respectively. The severity of conductive hearing loss correlated with the size of the eardrum perforation. Male patients were more (68.008%) as compared to females (31.992%). Left ear was more commonly involved (72.16%) than right ear (28.74%). The age ranged from 10-60 years with a mean age of 26.3 years. All the patients demonstrated acute perforation of the ear drum that was confined solely to pars tensa. Anterior perforation occurred in 65 patients (12.46%) while posterior perforation occurred in 152 patients (29.12%). About (58.42%) i.e. 305 of the perforations involve adjacent portion of both anterior and posterior halves of tympanic membrane. Closure of air-bone gap following healing was significant p<0.01 while recovery of BC abnormality was less favorable. The most common cause of hearing loss was due to slap by spouses (among females) and slap by security personnel (among males), followed by fight among students. So, there is the need to educate on alternative punitive measure among students and security agents, early identification, evaluation and referral of patients reduces the attendant morbidity.