Exposure to an acute blast may damage the external, middle and inner ear.


Clinical findings may include one or more of the following:

(1) tinnitus

(2) otalgia

(3) bleeding from the ear

(4) pressure sensation similar to that of eustachian tube blockage

(5) vertigo

(6) foreign material from blast, in the external or middle ear

(7) perforation in the tympanic membrane

(8) dislocation of ossicles (malleus, incus, and/or stapes)

(9) conductive and/or sensorineural hearing loss


Pain may occur if the patient is evacuated in a nonpressurized aircraft without adequate decompression of the middle ear.


Squamous epithelium displaced into the middle ear can give rise to cholesteatoma.


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