Clinical audiometric patterns of hearing loss following blast-related injury in U.S. military personnel

Abstract

Objective: To identify clinical audiometric patterns of hearing loss following blast-related injury (BRI) in US military personnel.

Design: Retrospective cohort study.

Study sample: A total of 1186 male Navy and Marine Corps service members with normal hearing thresholds on pre-injury audiograms who had post-injury audiograms in the Blast-Related Auditory Injury Database.

Results: Low- and high-frequency pure-tone averages (PTAs) were significantly higher in those with BRI than non-blast-related injury (NBRI) for both ears (p < 0.001 for all comparisons). Overall, 172 (15%) service members met criteria for post-injury hearing loss and were categorised into PTA or single-frequency hearing loss subgroups. PTA hearing loss was more common in the BRI group (50% vs. 33%, p < 0.036), whereas single-frequency hearing loss was more common in the NBRI group. Most hearing loss was mild to moderate in degree, and three distinct audiometric patterns emerged (i.e. flat, sloping and rising). A flat pattern was the most prevalent configuration among those with PTA hearing loss, especially bilateral loss. Single-frequency hearing loss was mostly unilateral and high frequency.

Conclusions: In this study, BRI produced hearing loss across test frequencies, generating more clinically actionable post-injury audiograms than NBRI. We found that post-injury audiometric patterns of hearing loss among military personnel may vary.

Keywords:

• Audiometric pattern
• blast injury
• hearing loss
• military
• noise exposure
• severity of hearing loss

Acknowledgments

We thank Carrie Brown and Michelle LeWark for technical review and support.

Disclosure statement

I am a military service member or employee of the US Government. This work was prepared as part of my official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the US Government. Title 17, U.S.C. §101 defines a US Government work as work prepared by a military service member or employee of the US Government as part of that person’s official duties.

Report No. 19-52 was supported by the Congressionally Directed Medical Research Program award number W81XWH-14-CRMRP-NSRRA under work unit no. 60808. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the US Government. No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Congressionally Directed Medical Research Program award number W81XWH-14-CRMRP-NSRRA.