Section: 
Reviews
ReviewsFeatures of contusion blast injury in modern combat conditions: etiopathogenesis, clinical picture, military medical examination
V. G. Mironov (1), R. G. Makiev (2), I. V. Mironov (3), P. M. Sheshegov (4), L. P. Slivina (5), V. N. Zinkin (6)
(1) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russin Federation, (2), (3) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation, (4), (5), (6) Volgograd State Medical University, Volgograd, 400131, Russian Federation
UDK: УДК 616.31-001.31-092:623.565.23:343.148.22
DOI: https://doi.org/10.18692/1810-4800-2024-6-125-136
ABSTRACT
Abstract. The features of modern combat operations are shown. The characteristic of the damaging factors in the genesis of concussion injury is given: an air shock wave and a high-intensity acoustic pulse. The zones of transformation of the air shock wave are substantiated. The leading criteria for the effectiveness of the shock wave are excess pressure in the shock wave front, the compression phase. The features of the acoustic pulse in the use of modern ammunition are substantiated (high intensity, increased duration, the spectrum is saturated with low and infrasound frequencies). The mechanism of explosive trauma is primarily due to the effect of an air shock wave and high-intensity acoustic pulses on the human body. The mechanisms of their interaction with the human body are based on deformation, shock acceleration, and barometric pressure drop. As a result, the clinical picture of explosive trauma is dominated by fractures of the limbs, bruises (contusion) of the brain, heart, lungs, abdominal organs, and lesions of the hearing organ (barotrauma, acoustic barotrauma, acoustic trauma). The nature and extent of the lesion depend on the specific conditions of exposure: distance, power and type of explosion, explosive as well as the degree of protection of a person. Clinical forms of contusion injury are presented. It can be of peripheral and central origin. The clinical manifestations of peripheral contusion injury include barotrauma, acoustic barotrauma, acoustic trauma, the diagnosis and examination of which are well studied. A special group consists of affectogenic, neurodynamic, or central air-contusion lesions. They are characterized by the absence of external signs of injury, and internal injuries are often not diagnosed, so their severity is underestimated. The clinical manifestations of this form of contusion are mainly auditory-speech disorders: deafness (deafness, dumbness), aphasia, dysarthria, dysphonia, etc. In addition, affective trauma is characterized by disorders that occur in the central and autonomic nervous system. The features of the medical examination of contusion injury and its disadvantages are shown. Suggestions are given for the continuation of scientific research on contusion injury.
Publication date:
17.12.2024
Keywords:
contusion injury, air shock wave, acoustic pulse, etiopathogenesis, clinical forms, military medical examination
For citation:
Mironov V. G., Makiev R. G., Mironov I. V., Sheshegov P. M., Slivina L. P., Zinkin V. N. Features of contusion blast injury in modern combat conditions: etiopathogenesis, clinical picture, military medical examination. Russian Otorhinolaryngology. 2024;23(6):125-136. (In Russ.) https://doi.org/10.18692/1810-4800-2024-6-125-136