Abstract

Relevance: As a result of hostilities, one of the main options for damage to ENT organs is injury to the middle and inner ear. In the current wartime, it is necessary to thoroughly study the clinical features of the course of middle ear barotrauma, bacterial contamination of the external auditory canal of people in field conditions, as well as options for surgical care for patients who have received mine-explosive injuries.

Objective: To investigate the clinical course of ruptured eardrum in servicemen who received mine-explosive trauma in combat conditions; to assess the effectiveness of surgical treatment, namely membranoplasty, with different types of autologous tissues; to study the microflora of the external auditory canal in servicemen who are in field conditions in the South-Eastern

Materials and methods: An analysis of 110 medical histories of military personnel who were hospitalized for traumatic rupture of the eardrum and received surgical treatment – membranoplasty with a fascial or cartilage autograft was conducted. The term of surgical intervention after the injury was 40-60 days. At the preoperative stage, the injured soldiers underwent a general examination of the ENT organs, endoscopic visualization of the external auditory canals and eardrums, audiometric examination of auditory function, and bacteriological examination of the microflora of the external auditory canals.

Results and discussion: The peculiarities of rupture of the eardrum due to mine-explosive trauma are perforations of the anterior sections, which require more complex surgical access. When performing pure tone threshold audiometry, all patients had combined hearing loss of grades I-IV. Among the surgical findings during tympanotomy, a rupture of the ossicular chain was noted in 7.3% of cases, which was an indication for reconstruction of the sound-conducting apparatus. Also, in 1.8% of cases, a “pearl” of cholesteatoma was found intraoperatively in the tympanic cavity, which could have caused a serious complication in the future. The spectrum of microflora of the external ear of patients in field conditions did not have significant deviations from the normal biocenosis.

Conclusions: The peculiarities of rupture of the eardrum in military personnel due to mine-explosive trauma are perforations of the anterior sections, which require more complex surgical access. The use of autologous tissues of the fascia of the temporal muscle or cartilage of the auricle gives a high positive morphological result -88.4% and 95.7%, respectively. It is advisable to perform surgical intervention no earlier than 1.5-2 months after the injury, to wait for possible self-healing of the eardrum, provided that a strict hygiene regimen is observed, but preferably no later than 6 months, to prevent the development of chronic otitis with a possible complication, such as cholesteatoma. When planning a surgical intervention, the otosurgeon must have knowledge of various methods of surgical repair of the eardrum and be prepared for complex reconstruction of the sound conduction apparatus, sometimes using artificial ossicular prostheses.

Key words: acubarotrauma, tympanic membrane rupture, tympanoplasty.