One week from today, 36,000 people will run the 118th Boston Marathon, the world’s oldest annual marathon. Just one year ago, this iconic event was torn apart by a horrific bombing at the finish line. As we approach the anniversary, we remember those affected by the terrible events of April 15th, 2014 and examine the acoustic trauma experienced by many who were near the blast.
That evening, the emergency department at Massachusetts Eye and Ear Infirmary was full. Patients who were cleared of other major medical trauma next door at Massachusetts General Hospital arrived to be evaluated for ear pain, hearing loss and other head and neck injuries. According to an article in the Hearing Journal, “most patients had hearing loss, tinnitus, and mild disequilibrium. On exam, they had tympanic membrane perforations, large and small. Pieces of metallic shrapnel were identified and carefully removed from patients’ faces, necks, and arms. Audiograms revealed both conductive and sensorineural hearing loss, often worse in the ear facing the blast. Careful eversion of perforated drum edges was performed, and selected patients with sensorineural hearing loss were treated with oral steroids.”
In the following weeks, treatment recommendations were made based on experience with traumatic perforations from other causes, clinical and scientific literature on noise-induced hearing loss, and recommendations from military literature and military colleagues. However, this experience led them to acknowledge that there is a lot we don’t know about blast-related ear injury. Since the bombing, they have been conducting research into the consequences of acoustic trauma. Results have not yet been published, but we hope that it will lead to better treatment of these types of injuries.