ABSTRACT
In recent decades, acoustic shock and explosion traumas have increased in frequency in the general population. Beside the use of fireworks and firearms, airbag ignitions and explosions caused by terror or suicidal acts are also relevant. Depending on duration and strength of the sound pressure affecting the human ear, isolated inner ear damage or additional ear drum perforation and interruption of the middle ear ossicle chain can result. By means of otoscopy, pure tone audiometry, measurement of otoacoustic emissions, and other neurootological examinations, the severity of the trauma can be determined. With prompt and adequate therapy, permanent hearing loss can be minimized. In particular, the measurement of otoacoustic emissions allows conclusions to be made on the functionality of the outer hair cells which are damaged first in most cases. Histological investigations on noise-exposed cochleas show extensive damage to the outer hair cells in the frequency range between 1.0 and 4.0 kHz, which correlates well with audiometric measurements.
Subject(s)
Blast Injuries/etiology , Ear, Inner/injuries , Ear, Middle/injuries , Explosive Agents/adverse effects , Hearing Loss, Noise-Induced/etiology , Tympanic Membrane Perforation/etiology , Air Bags/adverse effects , Blast Injuries/diagnosis , Blast Injuries/therapy , Craniocerebral Trauma/diagnosis , Craniocerebral Trauma/etiology , Craniocerebral Trauma/therapy , Firearms , Hearing Loss, Noise-Induced/diagnosis , Hearing Loss, Noise-Induced/therapy , Humans , Military Personnel , Multiple Trauma/diagnosis , Multiple Trauma/etiology , Multiple Trauma/therapy , Otoacoustic Emissions, Spontaneous , Tympanic Membrane Perforation/diagnosis , Tympanic Membrane Perforation/therapyABSTRACT
Facial pain and headaches are heterogeneous, therefore, a differential diagnosis, interdisciplinary survey and mapping of the pain symptoms are essential for determination of treatment concepts. This requires an otorhinolaryngology (ENT) adapted zoning of the various pains in the head and neck in line with the classification of the International Headache Society (IHS). In this review, idiopathic, symptomatic and neuralgic facial pain and headaches will be differentiated and classified according to their location from the ENT medical point of view. This provides otolaryngologists with a simplified, targeted diagnosis and subsequent indication for therapy.
