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

Stephen A. Fausti, Debra J. Wilmington, Frederick J. Gallun, Paula J. Myers, James A. Henry
2009 Journal of rehabilitation research and development  
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
more » ... enging in the TBI population, as symptoms can be mistaken for posttraumatic stress disorder, mentalhealth 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. Abbreviations: ABR = auditory brainstem response, ASSR = auditory steady-state response testing, BPPV = benign paroxysmal positioning vertigo, CAP = central auditory processing, CNS = central nervous system, FM = frequency modulation, LAV = light-armored vehicle, OAE = otoacoustic emissions, PTM = Progressive Tinnitus Management, PTSD = posttraumatic stress disorder, SNHL = sensorineural hearing loss, TBI = traumatic brain injury, TM = tympanic membrane, VA = Department of Veterans Affairs, VRT = vestibular rehabilitation therapy.
doi:10.1682/jrrd.2008.09.0118 fatcat:qu77fhqbkbd5thkq3hmoeqs3ne