Audiological and functional outcomes two years after combat noise exposure on october 7, 2023
2Hearing and Speech Institute, Soroka University Medical Center, Israel
3Department of Communication Disorders, Auditory Perception Lab in the Name of Laurent Levy, Ariel University, Israel
4Department of Communication Disorders, Audiology and Hearing Physiology Research Lab, Ariel University, Israel
Background:
The October 7, 2023 combat noise event exposed thousands of military and civilian personnel without adequate hearing protection. Long-term auditory outcomes, including symptom persistence, functional disability, and rehabilitation uptake two years post-exposure, remains poorly characterized. This study aimed to characterize these outcomes and examine relationships between DPOAE and self-reported hearing handicap.
Methods:
Structured telephone interviews were conducted approximately two years post-exposure with 26 individuals exclusively exposed to combat noise on October 7, 2023, previously evaluated at Soroka University Medical Center. Participants completed the HHIA and THS questionnaires and reported on occupational impact, rehabilitation uptake, and disability compensation. Interview data were linked to initial audiological records including standard audiometry, EHF audiometry, and DPOAE. Analyses included binomial and McNemar tests, and Spearman correlations.
Results:
At follow-up, tinnitus and difficulty hearing in noise were reported by 100% of participants, hearing loss by 96%, and hyperacusis by 92%. Only 15% had sought hearing rehabilitation, significantly below the prevalence of reported hearing loss (McNemar p<.001). DPOAE abnormalities were present in at least one ear in 76.9% of participants and bilaterally in 53.8%. Neither DPOAE amplitudes nor pure-tone thresholds were significantly associated with self-reported hearing handicap on the HHIA scores. Audiometric severity was associated with formally recognized disability compensation, particularly for the left ear and worse-ear averages.
Conclusions:
Auditory symptoms remain highly prevalent two years after exposure, with a gap between symptom burden and rehabilitation uptake. DPOAE abnormality rates underscore the limitations of standard audiometry. The consistent dissociation between objective measures and self-reported handicap highlights the complexity of combat noise-induced auditory disability and the need for proactive rehabilitation outreach.