Audiometric configurations following exposure to explosions

Objective: To determine the configurations in pathologic audiograms obtaine d in patients shortly after exposure to an explosion. Design, Setting, and Patients: Audiograms were performed in 143 patients (2 86 ears; 76 males and 67 females, with a mean age of 34.6 years [range, 11- 79 years]) sent to the Department of Otolaryngology and Head and Neck Surge ry in a city hospital located in the center of Jerusalem, Israel, after bei ng injured in 4 severe explosions occurring in Jerusalem during 1995-1997. Most of the audiograms were obtained within 4 hours after the explosion, an d the remaining were obtained within 4 days of the explosion. Results: Of 200 pathologic audiograms, 93 (46%) showed a downward slope con figuration, 82 (41%) showed a dip configuration, and 25 (12%) were flat. Th ere were 38 audiograms (19%) with 6-kHz dips. In 82% of the patients, the a udiometric configurations were similar in both ears. Patients with a slope configuration on the audiogram were significantly older than those with a d ip configuration (mean age, 40.8 vs 32.8 years; P<.01). Conclusions: There does not appear to be a single typical audiometric confi guration in patients exposed to explosions. The slope and dip configuration s are most frequently seen and are approximately equal in their incidence. This observation may lead to better understanding damage to the inner ear a s a result of an explosion. This study is distinctive because of the large number of audiograms obtained and the fact that most of them were obtained immediately after the explosion.