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Tzu Chi Med J 2004 � 16 � No. 3 �� ! OMV

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Tzu Chi Med J 2004 � 16 � No. 3ONM �� !

Ear Blast Injury—A Case Report

Shih-Han Hung1, Su-Yi Hsu

2, Pa-Chun Wang

1,3

Department of Otolaryngology1, Cathay General Hospital, Taipei, Taiwan; Department of Otolaryngology2,

Cathay General Hospital Hsinchu Branch, Hsinchu, Taiwan; Department of Public Health3, China Medical

University, Taichung, Taiwan

ABSTRACTThe auditory apparatus is the most vulnerable organ system to a blast injury, but blast damage to the auditory system isoften overlooked in the emergency room when management of other life-threatening major vital organ trauma isprioritized. We report on a Caucasian patient who survived the Bali Island bombing in October 2002. The patientpresented with dizziness, otorrhea, conductive hearing loss, and bilateral tympanic membrane perforation. CSF leak-age and incus-stapes joint dislocation were found in the left ear during the operation. Spontaneous healing of the righttympanic membrane perforation was noted 3 months after the blast injury. His conductive hearing loss returned tonormal, and the CSF leakage ceased after proper middle ear reconstruction. Ear blast injury is rarely reported inpeacetime literature; we discuss the mechanism, pathophysiology, management, and outcomes of this unusual situation.(Tzu Chi Med J 2004; 16:205-210)

Key words: ear blast injury, conductive hearing loss, CSF leakage

Received: July 23, 2003, Revised: August 29, 2003, Accepted: October 24, 2003Address reprint requests and correspondence to: Dr. Pa-Chun Wang, Department of Otolaryngology, Cathay GeneralHospital, 280, Section 4, Jen Ai Road, Taipei, Taiwan