title: Internal Jugular Vein Compression: A Novel Approach to Mitigate Blast Induced Hearing Injury.
abstract: Internal jugular vein (IJV) compression before blast injury will lead to reduced risk of traumatic hearing injury following exposure to a blast injury.
  
  
  
  IJV compression and its effects on not only intracranial, but also intracochlear pressure may potentiate blast induced hearing injury, therefore, precluding its use as a prophylactic therapy for blast induced traumatic brain injury.
  
  
  
  Twenty Sprague Dawley rats were exposed to a 17.9 ± 0.4 PSI (195.8 dB SPL) right sided shock wave in which 10 had application of a custom IJV compression collar before injury. All rodents received baseline and post blast injury otoacoustic emission (OAE) and auditory brainstem response (ABR) testing followed by cochlear histology.
  
  
  
  IJV compression was shown to significantly reduce ABR and OAE threshold shifts in comparison to the non-intervention group by: 14.9 ± 4.8 dB (right ear ABR 0.5 kHz Day 1 post blast, p = 0.01), 13.1 ± 4.9 dB (right ear ABR 4 kHz Day 1 post blast, p = 0.04), 16.5 ± 4.5 dB (right ear ABR click Day 1 post blast, p = 0.003), 12.1 ± 4.6 dB (right ear ABR click Day 6 post blast, p = 0.04), and 14.0 ± 3.2 dB (both ears OAE 3.2-10 kHz, p < 0.0001). Also, those animals with collar application had a greater number of total hair cells per mm from 70 to 100% distance from the cochlear apex following blast injury in comparison to those without intervention (blast: 211.8 ± 27.5 versus blast+collar: 355.5 ± 39.5 [p = 0.0002]).
  
  
  
  This study supports the use of IJV compression in a pre-clinical model as a new prophylactic mechanism to combat blast induced hearing injury.
authors.affiliation: *Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois †Department of Neurosurgery, University of Florida, Gainesville, Florida ‡Department of Surgery, Division of Otolaryngology §Department of Neurophysiology, NorthShore University HealthSystem, Evanston, Illinois ||Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Brian
authors.initials: B
authors.lastname: Sindelar
authors.forename: Michael
authors.initials: M
authors.lastname: Shinners
authors.forename: Sydney
authors.initials: S
authors.lastname: Sherman
authors.forename: Kevin
authors.initials: K
authors.lastname: Novak
authors.forename: Kristine
authors.initials: K
authors.lastname: Erickson
authors.forename: Vimal
authors.initials: V
authors.lastname: Patel
authors.forename: Paul
authors.initials: P
authors.lastname: Kubilis
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.forename: John
authors.initials: J
authors.lastname: Finan
authors.forename: Julian E
authors.initials: JE
authors.lastname: Bailes
mesh_terms: D000818:Animals; D001753:Blast Injuries / Q000150:complications*; D003051:Cochlea / Q000473:pathology; D004195:Disease Models, Animal; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D006317:Hearing Loss, Noise-Induced / Q000209:etiology* / Q000503:physiopathology; D007601:Jugular Veins; D008297:Male; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D051381:Rats; D017207:Rats, Sprague-Dawley