Concussive effects of bomb blast on the ear

Abstract

A Belfast [Northern Ireland,] bomb blast caused 60 perforated tympanic membranes; the cases are reviewed. The shock front of a blast wave was irregular and some persons, close to the blast, escaped without any ear damage. Perforations due to the blast occurred in the pars tensa and were probably caused by the positive phase of the blast, as indicated by the histological finding of squamous epithelium in the middle ear and the formation of epithelial pearls. The everted edges that sometimes were seen were caused secondarily by the suction effect of the negative phase. A conservative approach resulted in spontaneous healing in the majority of cases. Rupture of the tympanic membrane did not appear to have a protective effect on the inner ear. Sensorineural hearing loss for the speech frequencies tended to, but did not always, recover spontaneously.