Logo for the Journal of Rehab R and D

Volume 46 Number 6, 2009
   Pages 797 — 810

Abstract — Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

Stephen A. Fausti, PhD;1 Debra J. Wilmington, PhD;1* Frederick J. Gallun, PhD;1 Paula J. Myers, PhD;2 James A. Henry, PhD1

1Department of Veterans Affairs (VA) Rehabilitation Research and Development Service, National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR; and Department of Otolaryngology, Oregon Health & Science University, Portland, OR; 2James A. Haley Veterans' Hospital/Polytrauma Rehabilitation Center, Tampa, FL

Abstract — The dramatic escalation of blast exposure in military deployments has created an unprecedented amount of traumatic brain injury (TBI) and associated auditory impairment. Auditory dysfunction has become the most prevalent individual service-connected disability, with compensation totaling more than 1 billion dollars annually. Impairment due to blast can include peripheral hearing loss, central auditory processing deficits, vestibular impairment, and tinnitus. These deficits are particularly challenging in the TBI population, as symptoms can be mistaken for posttraumatic stress disorder, mental-health issues, and cognitive deficits. In addition, comorbid factors such as attention, cognition, neuronal loss, noise toxicity, etc., can confound assessment, causing misdiagnosis. Furthermore, some auditory impairments, such as sensorineural hearing loss, will continue to progress with age, unlike many other injuries. In the TBI population, significant clinical challenges are the accurate differentiation of auditory and vestibular impairments from multiple, many times overlapping, symptoms and the development of multidisciplinary rehabilitation strategies to improve treatment outcomes and quality of life for these patients.

Key words: auditory dysfunction, blast, central auditory processing, hearing loss, polytrauma, prevention, rehabilitation, tinnitus, traumatic brain injury, vestibular.


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