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Ten years after the 7/7 bombings - an otologic perspective

Presenting Author: Sherif Habashi

Published online by Cambridge University Press:  03 June 2016

Sherif Habashi  and
Ghous Handoo
Sherif Habashi
Affiliation:
Royal Free London NHS Foundation Trust
Ghous Handoo
Affiliation:
Royal Free London NHS Foundation Trust
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Abstract

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Learning Objectives: Physical injuries suffered by victims of terrorism may be identical to those caused by accident. However, the psychological Impact of terrorism may worsen the prognosis for fully recovery. It is important that victims of terrorism receive the most expert assistance at the earliest possible stage if they are to have the best chance of complete recovery from their physical injuries.

Introduction: The London bombings of 7th July 2005 left 56 dead (including the perpetrators) and over 700 injured. Ear damage is extremely common following exposure to explosions. Those injuries include tympanic membrane rupture, which may or may not heal spontaneously, sensorineural hearing loss, tinnitus, and vestibulopathy. The prognosis is variable and may be influenced by many factors.

Method: We present three patients treated in our institution who each suffered ear damage during the 7/7 bombings.

Case 1: a 19 year old autistic man sustained a ruptured left tympanic membrane and when initially seen had an actively discharging middle ear. Microsuction was performed and topical antibiotic drops prescribed.

Case 2: a 60 year old civil servant sustained a central tympanic membrane perforation with associated mixed hearing loss and tinnitus. After this failed to heal tympanoplasty was performed.

Case 3: a 21 year old lady sustained bilateral tympanic membrane perforations which failed to heal. She underwent surgery on both ears including revision on the first side.

Results: The first patient's tympanic membrane healed spontaneously but he represented several times with otitis externa in the previously damaged ear. The second patient's surgery was successful in closing the perforation but he is left with persistent tinnitus and is now using hearing aid. The third patient had and iatrogenic middle ear cholesteatoma following her first operation resulting in ossicular erosion. After revision surgery and repair of the contra lateral perforation she had been left with mild bilateral hearing loss. 10 years on she has tinnitus which at times is disabling, recurrent BPPV and chronic imbalance.

Conclusion: Blast injury to the ear can result in a spectrum of injuries which may or may not leave lasting disability. The psychological trauma inflicted on victims of terrorism can have a significant impact on their ability to cope with tinnitus and vestibular symptoms.