Mann mit Knalltrauma

Bang trauma: treatment, causes, symptoms

Bang trauma is an acoustic trauma. It occurs when the hair cells in the inner ear are damaged. This can occur with increased sound exposure to the ear, which is brief - between one and two ms - but intense. This is because as soon as a certain pressure threshold is exceeded, the human ear is no longer able to adapt. Consequently, damage to the hearing organ occurs.

We have summarized all relevant information on the topic of acoustic trauma. So below you will find information on causes and symptoms. In addition, you will learn how the diagnosis "blast trauma" is made and which therapeutic approaches are possible. If you have any questions, we will be very happy to answer them without obligation and free of charge.

Reasons and causes for a blast trauma

The reasons for acoustic blast trauma are diverse. Typical examples include:

  • A powerful blow to the ear
  • Lightning strike
  • Bursting near the ear
  • Bang body explosion near the ear
  • Shooting near the ear

These causes can lead to damage to the hair cells through a disruption in their metabolism. Consequently, the oxygen supply is no longer sufficient and free radicals can no longer be formed. In addition, a mechanical damage is also possible. Initially, the basal area of the cochlea is affected in this case, under which the high-frequency range falls.

What are the symptoms of acoustic trauma?

A typical symptom of acoustic trauma is the sensation of a blocked ear. It also shows hearing loss on the affected side. Other common symptoms of acoustic trauma include:

Most of the time, the blast trauma is only unilateral and should show animprovement of symptoms within the first few days. A worsening of symptoms is generally not expected.

How is a blast trauma diagnosed?

For a diagnosis, your ear, nose, and throat doctor will create a hearing curve. Through this curve, which is displayed in a audiogram, a sensorineural hearing loss can be detected. In the curve, this can be identified by the shape, which shows a dip at 4000 Hz or a drop at high sound frequencies.

In the case of a bang trauma, the so-called SISI test turns out to be positive. This means that the span between the comfort threshold and the hearing threshold is smaller than in people who can hear normally. This circumstance can be attributed to the damaged outer hair cells. In a healthy ear, a relatively wide spectrum of sounds and their intensity can normally be perceived. In the case of sensorineural hearing loss, however, the perception of loudness variation is limited.

In addition, another functional area of the outer hair cells is affected: The otoacoustic emissions can no longer be measured when they are damaged. However, because there is additional noise exposure when testing emissions, the test is not performed until about one week after the trauma has occurred.

What are the therapeutic options for a blast trauma?

The first therapeutic measure isinfusion therapy with procaine and HAAES. Treatment is virtually analogous to that for hearing loss. Furthermore, cortisone may be administered. If neither of these therapies is effective, hyperbaric oxygen therapy is used.

In any case, therapy should be started as early as possible because this is crucial for the prognosis. The earlier therapy begins, the lower the risk of permanent damage from the blast trauma.

Surgery is performed for a blast trauma only if either one or both windows in the inner ear are damaged or a perilymph fistula has formed. In this case, there is a pathologic connection from the perilymph space to the middle ear. Both fistula and a damaged window are treated by rehabilitating the tympanic membrane opening. This procedure is called tympanotomy.

Can a hearing aid help with blast trauma?

When a blast trauma lasts for a long period of time, in most cases there is hearing damage in the high-frequency range. This hearing loss can usually be compensated very well by a hearing aid. This significantly improves the quality of life. Especially in noisy environments, the improved hearing is perceptible, which is recovered by means of the hearing aids.

What is the prognosis for acoustic trauma?

The prognosis is generally good. After circa six weeks, an improvement of the symptoms may be expected. Often, hearing is completely restored. If the complaints still persist after six weeks, the chance of success for a cure decreases. A permanent hearing impairment can therefore not be ruled out.