耳爆炸傷—病例報告

The auditory apparatus is the most vulnerable organ system to a blast injury, but blast damage to the auditory system is often overlooked in the emergency room when management of other life-threatening major vital organ trauma is prioritized. We report on a Caucasian patient who survived the Bali Island bombing in October 2002. The patient presented with dizziness, otorrhea, conductive hearing loss, and bilateral tympanic membrane perforation. CSF leakage and incus-stapes joint dislocation were found in the left ear during the operation. Spontaneous healing of the right tympanic membrane perforation was noted 3 months after the blast injury. His conductive hearing loss returned to normal, and the CSF leakage ceased after proper middle ear reconstruction. Ear blast injury is rarely reported in peacetime literature; we discuss the mechanism, pathophysiology, management, and outcomes of this unusual situation.