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Abstract: Deafness due to firecrackers is called blast deafness, and hearing loss often peaks within a short period of time. This article presents a 40-year-old male patient who presented with “hearing loss in the left ear with tinnitus due to firecrackers” and was diagnosed with blast deafness. The patient’s condition improved, the symptoms of vertigo disappeared, and the hearing in the right ear gradually recovered after standardized medication.
Basic information】Male, 40 years old
Disease Type】Explosive deafness
Hospital】Northern War Zone General Hospital
Date of Consultation】February 2021
Treatment plan】Intravenous medication (Ginkgo biloba extract injection, adenosine cobalamin for injection) + oral medication (vitamin B complex tablets, Ginkgo biloba extract tablets, methylcobalamin dispersible tablets)
Treatment period】10 days of intravenous treatment in outpatient clinic, 15 days of oral medication
Treatment effect] The vertigo symptoms disappeared and the hearing in the right ear gradually recovered.
I. Initial consultation
Mr. Zhou reported that he was hit by a strong explosion when he was setting off firecrackers on New Year’s Eve and felt a hearing loss in his left ear and a buzzing sound in his ear. The endoscopy showed that the external auditory canals of both ears were clean, the right ear tympanic membrane was slightly congested and not perforated, and the hearing examination showed sensorineural hearing loss in the right ear but no abnormality in the left ear. Based on the patient’s medical history and auxiliary examinations, the patient was diagnosed as having blast deafness and was recommended to be treated with medication in a timely manner.
II. Treatment history
Firstly, the patient needed to ensure the external ear canal was clean and dry. The patient was given Ginkgo biloba extract injection to improve circulation, adenosine cobalamin for injection to nourish the nerves, and vitamin B complex tablets for oral administration. At the same time, the patient needed to go to the Department of Rehabilitation and Physiotherapy for hyperbaric oxygen therapy. It was suggested that the efficacy should be observed after 10 days of medication, but because of the patient’s previous history of hypertension, the blood pressure increased significantly during the treatment period, so hyperbaric oxygen could not be performed normally.
III. Treatment effect
The patient returned to the hospital after 10 days of medication and said that the vertigo symptoms disappeared, the hearing loss in the right ear improved significantly, and he could communicate with his family normally, but he still had tinnitus, which was intermittent and more obvious at night, and the re-examination of the endoscope indicated that the right external ear canal was clean and the tympanic membrane was no longer obviously congested. Since the recovery of tinnitus is slow, it is recommended to continue to apply drugs to improve circulation and nerve nutrition, and consolidate the treatment for 15 days, and oral ginkgo biloba extract tablets and methylcobalamin dispersible tablets are recommended.
IV. Precautions
After medication, the patient’s tinnitus and hearing loss have been relieved, which is gratifying as the treating doctor. Patients are advised to wear earmuffs to protect their ears and also need to pay attention to reducing contact with noise to reduce the stimulation of inner ear hair cells. It is important to eat a light diet and avoid spicy and irritating foods. It is also important to avoid smoking, drinking alcohol and staying up late. Continue to apply drugs that improve circulation and nerve nutrition to consolidate treatment, commonly used are Ginkgo biloba extract tablets and methylcobalamin dispersible tablets. You can listen to light music at night to cover up the tinnitus during sleep.
V. Personal insight
Be aware of safety in life, strengthen the management of explosives, high-pressure containers or flammable and explosive materials, and try to stay away from them. If you must contact them, you must wear protective equipment, such as ear plugs and earmuffs. If you have a blast injury to the ear, you must go to the hospital in a timely manner, the more timely the treatment, the better the outcome. During the treatment period patients need to maintain a good attitude, actively cooperate with the medication, adjust the treatment plan in a timely manner, and consider wearing hearing aids to improve the quality of life if the medication is not effective.