title: Tympanic membrane rupture in the survivors of the July 7, 2005, London bombings.
abstract: OBJECTIVE
  The goal of this study was to analyze the prevalence of tympanic membrane rupture in the survivors of the London bombings of July 2005 and to assess whether tympanic membrane rupture provides a useful biomarker for underlying primary blast injuries.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Survivors of the 4 blasts of London bombings on July 7, 2005. Data were gathered from medical records and the London's Metropolitan Police evidence documenting the injuries sustained by 143 survivors of the blasts. All patients with tympanic membrane rupture or primary blast injury were identified. Analysis was made of distance against prevalence of tympanic membrane rupture. Correlation between tympanic membrane rupture and other forms of primary blast injury was then assessed.
  
  
  RESULTS
  Results from the 143 survivors showed a 48% prevalence of tympanic membrane rupture across all 4 sites. Fifty-one patients had isolated tympanic membrane rupture with no other primary blast injuries. Eleven patients had tympanic membrane rupture and other primary blast injuries, but only one of these was an initially concealed injury (blast lung).
  
  
  CONCLUSIONS
  Tympanic membrane rupture in survivors of the London bombings on July 7, 2005, had a high prevalence affecting half of patients across a range of distances from the blasts. Tympanic membrane did not act as an effective biomarker of underlying blast lung. In a mass casualty event, patients with isolated tympanic membrane rupture with normal observations and chest radiography can be monitored for a short period and safely discharged with arrangement for ear, nose, and throat follow-up.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Barts and the London NHS Trust, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Radford
authors.forename: Hasu D L
authors.initials: HD
authors.lastname: Patel
authors.forename: Nicholas
authors.initials: N
authors.lastname: Hamilton
authors.forename: Mark
authors.initials: M
authors.lastname: Collins
authors.forename: Steven
authors.initials: S
authors.lastname: Dryden
mesh_terms: D001469:Barotrauma / Q000150:complications; D015415:Biomarkers; D001753:Blast Injuries / Q000150:complications*; D002960:Civil Disorders; D006801:Humans; D008131:London / Q000453:epidemiology; D054527:Mass Casualty Incidents; D009104:Multiple Trauma; D015995:Prevalence; D018058:Tympanic Membrane Perforation / Q000150:complications / Q000453:epidemiology*
chemical_list: D015415:Biomarkers