Lieutenant Colonel Jillyen Curry-Mathis, senior audiologist for the XVIII Airborne Corps, Fort Bragg, North Carolina, assesses noise levels outside a Soldier logistics support area. (Photo by SSG Keith Rainey, 62nd Medical Brigade)
With the requirement to maintain mobile functionality, the prototype consists of a Wireless Automated Hearing Test System headset, a computer tablet with custom, hearing-related software, and an integrated dosimeter. The package was augmented with a lightweight, compact immittance bridge and otoacoustic emissions system, used by audiologists to test the condition of the tympanic membrane (eardrum), middle and inner ear.
“This technology will enable audiologists to test hearing injury at the source with a better and quicker assessment to determine the next level of care and treatment,” said Hearing Center of Excellence Division Chief, Air Force Col. (Dr.) LaKeisha Henry. “Ultimately this capability will help save hearing and keep military members healthy and mission ready.”
Historically, audiologists are rarely deployed because hearing tests required a fixed hearing booth and the equipment is too cumbersome to move in deployed locations. “Moving around the battlefield is not easy, even in a mature theater. There is no forward line of engagement, and you don’t necessarily know where the enemy is or whether your patient will be accessible, but the timeline is so crucial to preserving treatment options,” said Curry-Mathis.
Hearing damage was therefore unknown, and not fully assessed or treated at or near the point of injury.
“Service members were either evacuated out for a perforated ear drum or other injury, which is costly in terms of manpower and expense, and in some cases unnecessary, or they were questioned if their hearing was okay, and if they said ‘yes,’ they were sent back to their units with no assessment. The risk was huge because we didn’t know the damage,” Curry-Mathis explained. “Given the fact that hearing loss is bloodless and painless, Soldiers often don’t understand the extent of the injury, or its consequences…and since they knew there was no treatment for it, they kept silent. That’s all about to change.”
During her short deployment, Curry-Mathis assessed 17 patients, nearly 30% of whom sustained a vestibular (balance) system injury from a high-risk exposure. With the portable equipment and/or a folding examination table, she conducted full diagnostic tests, identified and treated the balance dysfunctions found in up to 15% of blast exposures and concussions, and fitted service members with advanced hearing protection that protects while maintaining situational awareness.
“Research has demonstrated in multiple venues that even a mild or temporary hearing loss will significantly impact the survivability and lethality of a soldier, explained Curry-Mathis. “My job is to keep the injured Soldier safe while maintaining his combat effectiveness.”
When service members saw Curry-Mathis, she said they were relieved because it meant there was a good chance they would be able to stay in place and continue the mission.
In one case, a British infantry soldier was injured during a squad exercise after his left earplug came out while firing. By the time he put the earplug back in, he was exposed to 15 live rounds and sustained --sudden hearing loss.
After reporting the injury to his commander, he was medevaced to the Role 3 hospital for assessment by Curry-Mathis. “The next morning I did the battery of tests using the IPCAM system and determined he had a classic noise-induced hearing loss in the left ear,” explained Curry-Mathis.
This additional information provided to Lt. Col. (Dr.) Linda Orr, Royal Army Medical Corps’ ear, nose and throat surgeon, helped to define the soldier’s injury profile. “He had to be pulled out of theater, but we had a shot at recovery because we kept the timeline to treatment in England very short,” furthered Curry-Mathis. This is just one example of many where we may be able to intervene on a serious, and typically permanent injury.”
Although the assessment was given in theater, the soldier had to be flown back to England to receive specialized treatment only available to him in Birmingham. If administered within two weeks of the trauma, the treatment is extremely effective at blunting the injury or even recovering the hearing.
“I’m so thankful this worked out so well, and that we were able to provide Lieutenant Colonel Curry-Mathis with the equipment needed for this pilot. I’m especially excited that our partnerships with the UK have demonstrated further proof of concept of downrange mobile capabilities,” concluded Henry.