Extended high-frequency audiometry in battlefield acoustic trauma: diagnostic value and steroid treatment outcomes

OBJECTIVE: To evaluate the diagnostic utility of extended high-frequency audiometry (EHFA) and the efficacy of steroid therapy in acute acoustic trauma (AAT) during armed conflict. DESIGN: Retrospective cohort study at Rabin Medical Centre, Petach Tikva, Israel, October 2023-June 2024. STUDY SAMPLE: 130) groups. A paired cohort of 51 patients with complete baseline and follow-up audiometry was used for threshold change analyses. RESULTS: 0.042). No significant improvement was observed at EHF (10-18 kHz) in either group. CONCLUSIONS: EHFA effectively detects high-frequency cochlear injury missed by conventional audiometry. While unadjusted recovery was comparable between groups, adjusted analyses suggest steroids may not confer additional benefit beyond natural recovery at high frequencies. Given the non-randomised design, these findings are hypothesis-generating and steroid therapy should be considered selectively.