Tinnitus as an Indication of Head Injury

Letters to the Editor regarding the article The Documentation of Injuries Caused by Traffic Accidents by Prof. Dr. med. Benno Hartung, Andreas Schäuble, Dipl.-Ing. MEng CAISS, Prof. Dr. rer. biol. hum. Dipl.-Ing. Steffen Peldschus, Dr. med. Maximilian Schüßler, and Dr. med. Heinz-Lothar Meyer in issue 1/2024

The article highlights vividly the need for precise documentation of injuries, since this is the only way in which sufficient causality between an accident and the contracted injury can be reconstructed (1). Serious and severe injuries or accident patterns that lead to death are the focus of the considerations. In our view, the initial documentation in the emergency department in injured persons with a relevant orientation should also include symptoms such as newly occurring tinnitus, hearing loss, or cephalgia. It was shown, for example, that up to 53% of all patients with a head injury develop tinnitus (2) and that a craniocerebral injury constitutes a risk factor for developing tinnitus (3). If the symptoms are documented by a physician several weeks after their first occurrence, causality cannot be sufficiently established (4). A newly occurring fracture is consistent with a traffic crash in a very plausible way, whereas tinnitus can develop at any time and for diverse reasons—but it can also occur in association with a traffic accident. Comprehensive documentation of all symptoms after accidents or assaults is therefore even more important.

DOI: 10.3238/arztebl.m2024.0045

Flottillenarzt Dr. Theo Evers, Oberstarzt Prof. Dr. med. Matthias Tisch

Bundeswehrkrankenhaus Ulm, Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Ulm, [e-mail]

References

1. Hartung B, Schäuble A, Peldschus S, Schüßler M, Meyer HL: The documentation of injuries caused by traffic accidents. Dtsch Arztebl Int 2024; 121: 27–36

2. Feldmann H, Brusis T: Das Gutachten des Hals-Nasen-Ohren-Arztes. 8 rev. ed, Stuttgart: Thieme 2019

3. Kreuzer P, Landgrebe M, Vielsmeier V, Kleinjung T, De Ridder D, Langguth B: Trauma-associated tinnitus. J Head Trauma Rehabil 2014; 29: 432–42

4. Nondahl DM, Cruickshanks KJ, Wiley TL, et al.: The ten-year incidence of tinnitus among older adults. Int J Audiol 2019;49: 580–5