Correspondence
Traumatic Hearing Loss Following Air-Bag Inflation
N Engl J Med 1997; 337:574-575August 21, 1997
- Article
To the Editor:
Passenger-vehicle air bags are deployed by the rapid generation of a large volume of gas. This creates a brief (<100 msec), intense (150 to 170 dB) pressure wave that propagates through the passenger compartment.1 The precise sound pressure produced relates to factors such as vehicle size, the number of occupants, and ventilation. We describe a patient with traumatic hearing loss following air-bag inflation.
A 30-year-old man, wearing lap and shoulder belts, was driving a station wagon at about 40 km per hour (25 miles per hour) when the car went off the shoulder of a snow-covered road. There was no collision, but the undercarriage struck an obstacle, deploying the driver's air bag. At the moment of deployment, the driver was looking to his right, and the bag struck the left side of his face and head. Shortly thereafter he noticed a hearing loss and tinnitus in his left ear.
Physical examination was normal. No bruises were seen, and both tympanic membranes were intact. There was an absent ipsilateral acoustic reflex on the left. Audiometric thresholds in the left ear ranged from the level of a mild sensorineural hearing loss (a 35-dB hearing loss) at low frequencies to a profound hearing loss (no response at the limits of the test equipment) at 3000 to 8000 Hz. Hearing in the right ear was normal. Discrimination of speech monosyllables was excellent bilaterally. Although there were no pre-accident data on hearing, the patient had no history of hearing problems or tinnitus.
The patient was treated with a tapering course of methylprednisolone. Hearing in the left ear improved somewhat; however, a severe high-frequency sensorineural hearing loss and tinnitus continued in the left ear through 10 weeks of follow-up.
Physicians should be alert to the possibility of hearing loss as a consequence of air-bag deployment.
1 ReferencesMitchell B. Kramer, Ph.D.
Theodore G. Shattuck, M.D.
David R. Charnock, M.D.
Mid-Vermont E.N.T., Rutland, VT 05701-4591- Citing Articles (2)
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