Review of blast noise and the auditory system

The auditory system is particularly vulnerable to blast injury due to the ear's role as a highly sensi-tive pressure transducer. Over the past several decades, studies have used a variety of animal models and experimental procedures to recreate blast-induced acoustic trauma. Given the developing nature of this field and our incomplete understanding of molecular mechanisms underlying blast-related auditory disturbances, an updated discussion about these studies is warranted. Here, we comprehensively review well-established blast-related auditory pathology including tympanic membrane perforation and hair cell loss. In addition, we discuss important mechanistic studies that aim to bridge gaps in our current under-standing of the molecular and microstructural events underlying blast-induced cochlear, auditory nerve, brainstem, and central auditory system damage. Key findings from the recent literature include the as-sociation between endolymphatic hydrops and cochlear synaptic loss, blast-induced neuroinflammatory markers in the peripheral and central auditory system, and therapeutic approaches targeting biochem-ical markers of blast injury. We conclude that blast is an extreme form of noise exposure. Blast waves produce cochlear damage that appears similar to, but more extreme than, the standard noise exposure protocols used in auditory research. However, experimental variations in studies of blast-induced acoustic trauma make it challenging to compare and interpret data across studies. (c) 2022 Elsevier B.V. All rights reserved.

Automated summary

The article comprehensively reviews blast-related auditory pathology and discusses mechanistic studies on molecular and microstructural events. Key findings include the association between endolymphatic hydrops and cochlear synaptic loss, as well as blast-induced neuroinflammatory markers in the peripheral and central auditory system. Blast causes cochlear damage similar to, but more severe than, standard noise exposure.