소총 소음에 의한 음향외상의 임상양상
Clinical Characteristics of Acoustic Trauma Caused by Rifle Gunshot Noise
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참고문헌
초록
One of the major occupational hazards of working in the military service is being subjected to intense impulse noise, hence acoustic trauma. Acute acoustic trauma is a preventable disease, but the effective treatment modality has not been established yet. Acute acoustic traumas caused by exposure to rifle gunshot noise are common in young Korean males in the military service because of conscription policy. Through the analysis of the clinical presentation of acoustic traumas caused by rifle gunshot noise, we suggest effective preventive modalities. Subjects and Method：165 soldiers who had otologic symptoms after performing regular rifle gunshot exercise without any hearing protective measures were analyzed. They all had been tested with K2 rifle. History taking, physical examination, pure-tone audiometry, and impedence audiometry, temporal MRI, and Newmann’s tinnitus inventory questionnaire survey were performed. Results：Most common and annoying symptom was tinnitus. The average outcome of postexposure air conduction thresholds were 22.3dB HL in the affected ear and 11.8dB HL in the unaffected ear. There was no correlation between severity of tinnitus and severity of hearing loss. Asymmetry of hearing loss related to head position during gunshot was not found. This may be due to the fact that during the mass gunshot training, each patient can be influenced by the gunshot noise of the adjacent gunner’s shooting. Conclusion：Widening the distance between firing lanes and providing bilateral hearing protective devices against acoustic trauma must be taken into serious consideration. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:699-704)
Abstract
One of the major occupational hazards of working in the military service is being subjected to intense impulse noise, hence acoustic trauma. Acute acoustic trauma is a preventable disease, but the effective treatment modality has not been established yet. Acute acoustic traumas caused by exposure to rifle gunshot noise are common in young Korean males in the military service because of conscription policy. Through the analysis of the clinical presentation of acoustic traumas caused by rifle gunshot noise, we suggest effective preventive modalities. Subjects and Method：165 soldiers who had otologic symptoms after performing regular rifle gunshot exercise without any hearing protective measures were analyzed. They all had been tested with K2 rifle. History taking, physical examination, pure-tone audiometry, and impedence audiometry, temporal MRI, and Newmann’s tinnitus inventory questionnaire survey were performed. Results：Most common and annoying symptom was tinnitus. The average outcome of postexposure air conduction thresholds were 22.3dB HL in the affected ear and 11.8dB HL in the unaffected ear. There was no correlation between severity of tinnitus and severity of hearing loss. Asymmetry of hearing loss related to head position during gunshot was not found. This may be due to the fact that during the mass gunshot training, each patient can be influenced by the gunshot noise of the adjacent gunner’s shooting. Conclusion：Widening the distance between firing lanes and providing bilateral hearing protective devices against acoustic trauma must be taken into serious consideration. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:699-704)
참고문헌 (18)
- Nottet JB, "Otoacoustic emissions and persistent tinnitus after acute acoustic trauma", Laryngoscope, 116(6), pp.970~975 (2006)
- Kim HJ, "Noise induced hearing loss, in : Otorhinolaryngology Head and Neck surgery", pp.691~697 (2002), Ilchokak Publishers
- Mrena R, "Characteristics of acute acoustical trauma in the finnish defense forces", Int J Audiol, 43(3), pp.177~181 (2004)
- Lee ST, "The measurement of firing noise of K2 riffle at close distance", Journal of KSNVE, 11, pp.1123~1128 (2004)
- Dobie RA, "Noise induced hearing loss, in : Head and Neck Surgery-Otolaryngology", pp.2153~2163 (1998), Lippincott-Raven Publishers
- Keim RJ, "Sensorineural hearing loss associated with firearms", Arch Otolaryngol, 90(5), pp.581~584 (1969)
- Moon IS, "Noise-induced hearing loss caused by gunshot in South Korean Military service", Mil Med, 172(4), pp.421~425 (2007)
- Demaertrlaere L, "Treatment of acoustic trauma with hyperbaric oxygen", Acta Otorhinolaryngol Belg, 35(3), pp.303~314 (1981)
- Cakir BO, "Negative effect of immediate hyperbaric oxygen therapy in acute trauma", Otol Neurotol, 27(4), pp.478~483 (2006)
- Kang SH, "An epidemiologic & audiometric study of noise-induced hearing loss in subway workers", Korean J Otolaryngol-Head Neck Surg, 41(10), pp.1248~1253 (1998)
- Newman CW, "Retest stability of the tinnitus handicap questionnaire", Ann Otol Rhonol Laryngol, 104(9), pp.718~723 (1995)
- Lim DJ, "Functional structure of the organ of corti: A review", Hearing Res, 22, pp.117~146 (1986)
- Schleuning AJ Jr, "Tinnitus, in : Head and Neck Surgery-Otolaryngology", pp.2199~2206 (1998), Lippincott- Raven Publishers
- Anold S, "Studies of interaural attenuation to investigate the validity of a dichotic difference tone response recorded from the inferior colliculus in the chinchilla", J Acoust Soc Am, 107(3), pp.1541~1547 (2000)
- Johnsson LG, "Degeneration patterns in human ears exposed to noise", Ann Otol Rhinol Laryngol, 85(6), pp.725~739 (1976)
- Daniel E, "Noise and hearing loss: A review", J Sch Health, 77(5), pp.225~231 (2007)
- 전준, "소음성 난청에서 이명의 주파수와 작업장 소음 주파수의 관계", 대한이비인후과학회지 두경부외과학, 48(2), pp.142~145 (2005), 대한이비인후과학회
- Carter NL, "Effectiveness of foam earplug hearing protection for artillerymen firing L118", 119 105 mm howitzers, 1989, pp.154(9), 473~476