Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Travmatik İşitme Kayıplarının Adli Tıp Açısından Değerlendirilmesi: Retrospektif Tanımlayıcı Araştırma
Evaluation of Traumatic Hearing Loss in Terms of Forensic Medicine: Retrospective Descriptive Research
Burak KAYAa , Sait ÖZSOYb , Hüseyin BALANDIZb , Hakan GENÇc , Ayşe Nur BALABANd
aAdli Tıp Kurumu, Artvin Adli Tıp Şube Müdürlüğü, Artvin, Türkiye
bSağlık Bilimleri Üniversitesi Gülhane Tıp Fakültesi, Adli Tıp ABD, Ankara, Türkiye
cSağlık Bilimleri Üniversitesi Gülhane Tıp Fakültesi, Kulak, Burun ve Boğaz Hastalıkları ABD, Ankara, Türkiye
dSağlık Bilimleri Üniversitesi Gülhane Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2024;21(1):10-20
doi: 10.5336/forensic.2023-99753
Article Language: TR
Full Text
ÖZET
 Amaç: Travmalar, insan vücudunda tüm sistemleri etkileyebilecek yaralanmalara yol açabilmektedir. Bu çalışmada, travmatik işitme kaybı gelişen olguların adli tıbbi açıdan değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Travmatik işitme kaybı gelişen ve 2017- 2021 yılları arasında başvuruda bulunan adli olgulara ait veriler retrospektif olarak incelenmiştir. Bulgular: Değerlendirilen 408 olgunun %92'si erkek olup, yaş ortalaması 30,37±8,85 idi. Olguların çoğunluğu (%80,1) güvenlik güçleri personelinden oluşmaktaydı. Tüm olgular içinde en sık travma nedeni %65,5 ile patlama (blast) yaralanmalarıydı. Olguların %70'inde birden fazla frekansta işitme kaybı olduğu tespit edilmiştir. Olguların %69'unda düşük frekans, %62'sinde saf ses ortalaması, %93'ünde ise yüksek frekanslı işitme kaybı vardı. En ileri dereceli kaybın yıldırım-elektrik yaralanmaları bağlı oluştuğu, bunu ateşli silah ve patlama yaralanmalarının izlediği tespit edilmiştir. Patlama ve ateşli silah yaralanmalarına bağlı işitme kayıplarının diğer nedenlere göre daha az iyileştiği, en az iyileşmenin yüksek frekansta olduğu belirlenmiştir. Sonuç: Travmatik işitme kayıpları sıklıkla genç erkeklerde ve önlenebilir nedenlerle tüm frekanslarda görülebilmektedir. Yüksek enerjili travma olgularında işitme testleri ihmal edilmemeli, tüm frekanslar değerlendirilmelidir. ''Taktik Haberleşme ve Koruma Sistemleri'' yüksek şiddetteki seslerin şiddetini azaltarak kulak sağlığını korumaya yardımcı olurken düşük şiddetteki seslerin şiddetini artırarak da duymayı kolaylaştırmaktadır. Özellikle patlama ve ateşli silah yaralanmalarına sıklıkla maruz kaldığı bilinen güvenlik güçlerinde bu sistemlerin kullanımını yaygınlaştırılmalıdır.

Anahtar Kelimeler: Adli tıp; travma; patlama; işitme kaybı
ABSTRACT
 Objective: Traumas can lead to injuries that can affect all systems in the human body. In this study, it was aimed to evaluate the cases who traumatic hearing loss due to from a forensic medical point of view. Material and Methods: Data on forensic cases who developed traumatic hearing loss and applied between 2017-2021 were retrospectively analyzed. Results: Of the 408 cases, 92% were male, the mean age of the cases was 30.37±8.85 years. The majority of the cases (80.1%) were security forces. The most common cause of trauma were explosion (blast) injuries with 65.5%. Of the cases 70% had multiplefrequency hearing loss. Of the cases; 69% had low-frequency, 62% had pure-tone average, 93% had high-frequency hearing loss. It was determined that the most severe loss occurred due to electricity injuries, followed by firearm and explosion injuries. It was found that hearing loss due to explosion and firearm injuries healed less than other causes, and the least improvement was at high frequency. Conclusion: Traumatic hearing losses can often be seen in young men and at all frequencies for preventable reasons. Hearing tests should not be neglected in high-energy traumas, all frequencies should be evaluated. ''Tactical Communications and Protection Systems'' are reduce the intensity of high-intensity sounds and increase the intensity of low-intensity sounds that makes it easier to hear. The use of these systems should be expanded in security forces, which are known to be frequently exposed to explosions and gunshot injuries.

Keywords: Forensic medicine; trauma; explosion; hearing loss
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