Major Eric R. Helling, M.D., U.S. Army,
Staff Otolaryngologist,
Landstuhl Regional Medical Center
Traumatic tympanic membrane and ossicular chain injuries are common in the Military environment. We review our experience with the terrorist bombing victims at the U.S. Embassy, Nairobi, Kenya. Initial evaluation, findings and care of the patients evacuated to Landstuhl Regional Medical Center, Germany is reviewed. A combined Otologic and Audiologic team then deployed to Nairobi to assess all remaining Embassy personnel. A total of 147 audiologic evaluations and 30 physician evaluations are performed. A standardized injury diagram is used to assess and follow injuries. Perforations, and post traumatic cholesteatoma pearls are identified and surgical care is provided at Nairobi as appropriate. Two successful paper patch tympanoplasty and two cholesteatoma pearl excisions are performed. Out of the patient population, 16 initial perforations are identified and 5 persistent perforations at 5 months are identified. Perforation healing or failure is compared to overall size of perforation and presence of prior intervention. Our results are compared to Hostile Action Casualty System data and other large-scale otologic injury registries.