The effects of blast on the middle ear and cochlea are well documented. Vestibular damage resulting from blast is generally considered to be uncommon and insignificant. Five men who suffered blast injury to the ear were examined and followed up. The vestibular evaluation included electronystagmography and the smooth harmonic acceleration test. Acute vestibular symptoms and clinical and laboratory signs were found in three patients. These resolved along with the clinical improvement. Despite the evident vestibular compensation, permanent vestibulopathy was diagnosed in two patients. Our observations stress the importance of complete vestibular evaluation in cases of blast injury to the ear, regardless of a perhaps misleading clinical picture. Apart from the medicolegal aspects, such patients should be cautioned regarding the possibility of spatial disorientation during future exposure to unusual environmental conditions.
(Arch Otolaryngol Head Neck Surg. 1993;119:1362-1367)