The ability to detect, identify, and localize sounds during military operations is essential. Unfortunately, hazardous noise is a constant threat to military personnel during training exercises, active duty, and even off-the-job activities. Noise-related hearing loss and tinnitus (ringing in the ears) are the two most frequently reported disabilities of military service, affecting millions of veterans - including over 750,000 Gulf War era veterans alone.

To help address this threat to hearing and quality of life, the US military is focusing on early identification, immediate intervention, and an ongoing support system for veterans. Military researchers and clinicians recently collaborated to create a Clinical Practice Guideline (CPG) published last month by the Association of Military Surgeons. This CPG provides guidance for audiologists, otologists and emergency response personnel for the evaluation and treatment of service members exposed to blast injury and acoustic trauma. After life-threatening injuries have been addressed, damage to outer ear/eardrum and inner ear hearing and balance must be assessed, treated and monitored. The CPG is intended to increase awareness among hearing healthcare providers and to improve early identification and treatment of acoustic trauma.

To assist veterans and their families and researchers/providers on an ongoing basis, the Department of Defense has also created the Hearing Center of Excellence (HCE). The HCE is a multi-branch effort with the Veteran's Administration (VA) to promote prevention, diagnosis, treatment, rehabilitation and research of hearing loss and auditory injury. The HCE's primary responsibilities include:

• Develop a data registry to track hearing loss and auditory injuries across the Armed Forces, and share the registry data with the VA
• Encourage and facilitate hearing health research
• Develop best practices and clinical education, and
• Ensure the coordination and delivery of VA rehabilitation benefits and services to former Service members

The HCE educational website provides help and support for active military personnel, veterans, and their families. Visitors to the HCE website can find a provider and learn about VA healthcare and disability benefits. The Resources section provides training resources, real patient video stories, frequently asked questions, and links to helpful websites. Sign up for a newsletter and check out news articles, podcasts, and apps about hearing-related topics.

Hearing Center for Excellence website  

Additional resources:

• Esquivel, et al. (2018) Clinical Practice Guide: Aural Blast Injury/Acoustic Trauma and Hearing Loss. Military Medicine, Vol. 183, 9/10: 78-82.
• Wells, et al. (2015). Hearing loss associated with US military combat deployment, Noise Health. 2015 Jan-Feb; 17(74): 34–42. 
• Institute of Medicine (2006). Noise and Military Service: Implications for Hearing Loss and Tinnitus. Washington, DC: The National Academies Press.