The ENT problems following the Birmingham bombings

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Abstract
The ENT [ear, nose and throat] problems following the Birmingham [UK] bombings of 1974 are presented. It is during the positive phase of bomb blast that the [human] tympanic membrane ruptures. Spalling is a likely explanation for the mechanism of rupture of the tympanic membrane specially in large perforations. Tympanic membrane defects involving 80% of the surface area of the drumhead or more persisted, whereas those involving < 80% healed with conservative treatment. The majority of perforations (81.4%) healed spontaneously, with a 3-layered membrane. A month should be allowed for the healing of every 10% loss of the surface area of the drumhead. During surgical repair of persistent perforations, the malleus handle was on a deeper plain than the long process of the incus. Tympanic membrane perforations did not protect the inner ear, the sensorineural deafness producing either a high tone or a flat loss. Of the victims, l in 4 seen in the hospital complained of deafness. A patient who suffered blast injuries to the lung also developed cord palsy.