Sudden hearing loss after an explosion.

2. A tuning fork test is used to assess the type of hearing loss, whereas a pure tone audiometry (PTA) should be done to confirm and document the type and severity of the HL. In this case, PTA was consistent with profound right HL and severe-toprofound left HL, with features of mixed HL in at least in one ear (Figure 2). In this PTA, bone conduction had only been done on the left ear as the patient was having scalp injury around the right pinna and mastoid. Unfortunately, as the attenuation for bone is zero, the PTA will detect the best cochlea. The result for the best cochlea was thus shown on the PTA, but we could not confirm which side of the ear. That is why the conclusion was “mixed HL in at least one ear”. The effects of the explosive acoustic trauma also can be shown via a measurement of otoacoustic emissions (OAE).4 OAE check the movement of outer hair cells. Following the explosion, the hair cells may be damaged, causing disruption of the production of OAE. Answers