Blast wave exposure represents a primary cause of complex auditory and neurological injuries. The ear acts as a sensitive pressure transducer, making it exceptionally vulnerable to the intense mechanical forces of a blast. This review provides an overview of the multidimensional damage to the auditory system following blast events.
✦ The floor
Discussion
Signed responses from readers of the wire.
No actionable change for immediate practice, but clinicians working with military or blast-exposed patients should be aware that auditory damage extends beyond the ear into the central nervous system, warranting broader neurological screening.
Blast-induced hearing injury is the leading service-connected disability among veterans, and understanding its full central neurodegeneration pathway is critical for developing effective interventions and monitoring strategies.
- 01Narrative review covering the full spectrum of blast-induced auditory injury, from outer/middle/inner ear to the brain.
- 02Highlights mechanisms of central neurodegeneration following blast exposure, beyond classic peripheral hearing loss.
- 03Published in Iranian Journal of Otorhinolaryngology (2026).
- 04Relevant to military audiology, occupational hearing conservation, and traumatic brain injury clinics.
- 05No primary data; synthesises existing literature on blast pathophysiology.
Blast-induced auditory injury causes pathology that extends from peripheral ear structures to central neurodegeneration.
studysupported- PMID
- 42602452
- DOI
- 10.22038/ijorl.2026.93174.4098.
- Journal
- Iranian Journal of Otorhinolaryngology
- Publication type
- review
- Evidence level
- 5
- Population
- Literature review; no direct patient population
- Intervention
- Blast-wave exposure (review of injury mechanisms)
Primary outcomes
Characterisation of peripheral and central auditory injury mechanisms following blast exposure