目的:确定耳科症状和鼓膜穿孔的患病率,手术和保守治疗鼓膜穿孔的治愈率,以及恐怖爆炸的平民受害者的听力功能。
方法:在Medline上进行了系统评价,Embase,EMCare和CINAHL用于1945年1月1日至2023年5月26日之间的出版物。包括解决我们目标的定量数据研究。本评论在PROSPERO注册:CRD42020166768。在筛选的2611项研究中,纳入18项研究,包括前瞻性和回顾性队列研究。
结果:住院患者中鼓膜穿孔的百分比,在ENT随访和急诊就诊的比例为69.0%(CI55.5-80.5%),38.7%(CI19.0-63.0%,I20.715%)和21.0%(CI11.9-34.3%,I20.718%)分别。穿孔鼓膜自发愈合62.9%(CI50.4-73.8%,I20.687%)的病例和88.8%(CI75.9-96.3%,I20.500%)的病例手术后。爆炸后一个月内出现的常见症状是耳鸣84.7%(CI70.0-92.9%,I20.506%),听力损失83.0%(CI64.5-92.9%,I20.505%)和耳朵丰满度59.7%(CI13.4-93.4%,I20.719)。1-6个月的症状状态通常包括无症状57.5%(CI46.0-68.3%),听力损失35.4%(CI21.8-51.8%,I20.673%)和耳鸣15.6%(CI4.9-40.0%,I20.500%)。在爆炸发生的一个月内,最常见的听力异常是感音神经性听力损失,占26.9%(CI16.9-40.1%,I20.689%)耳朵43.5%(CI33.4-54.2%,I20.500)的人。
结论:鼓膜穿孔,主观听力损失,耳鸣,耳朵充盈和感觉神经性听力损失是平民恐怖爆炸的常见后遗症。
OBJECTIVE: Determine the prevalence of otological symptoms and tympanic membrane perforation, healing rates of tympanic membrane perforation with surgical and conservative management, and hearing function in civilian victims of terrorist explosions.
METHODS: A systematic review was conducted with searches on Medline, Embase, EMCare and CINAHL for publications between the 1st January 1945 and 26th May 2023. Studies with quantitative data addressing our aims were included. This review is registered with PROSPERO: CRD42020166768. Among 2611 studies screened, 18 studies comprising prospective and retrospective cohort studies were included.
RESULTS: The percentage of eardrums perforated in patients admitted to hospital, under ENT follow up and attending the emergency department is 69.0% (CI 55.5-80.5%), 38.7% (CI 19.0-63.0%, I2 0.715%) and 21.0% (CI 11.9-34.3%, I2 0.718%) respectively. Perforated eardrums heal spontaneously in 62.9% (CI 50.4-73.8%, I2 0.687%) of cases and in 88.8% (CI 75.9-96.3%, I2 0.500%) of cases after surgery. Common symptoms present within one month of bombings are tinnitus 84.7% (CI 70.0-92.9%, I2 0.506%), hearing loss 83.0% (CI 64.5-92.9%, I2 0.505%) and ear fullness 59.7% (CI 13.4-93.4%, I2 0.719). Symptomatic status between one and six months commonly include no symptoms 57.5% (CI 46.0-68.3%), hearing loss 35.4% (CI 21.8-51.8%, I2 0.673%) and tinnitus 15.6% (CI 4.9-40.0%, I2 0.500%). Within one month of bombings, the most common hearing abnormality is sensorineural hearing loss affecting 26.9% (CI 16.9-40.1%, I2 0.689%) of ears 43.5% (CI 33.4-54.2%, I2 0.500) of people.
CONCLUSIONS: Tympanic membrane perforation, subjective hearing loss, tinnitus, ear fullness and sensorineural hearing loss are common sequelae of civilian terrorist explosions.