Left-sided sensorineural deafness. Sensorineural deafness. Likuvannya. Have you noticed hearing loss? It’s dangerous to become a doctor


Bilateral sensorineural deafness and inflammation on one side occurs more often. Many patients suffer from acute loss of hearing and experience a lot of unpleasant symptoms. The correct solution when the first factors of illness are resolved is to contact an otolaryngologist.

A number of analyzes and investigations are required to determine the nature of the illness and its type. After all, there is nothing left to say about the appreciation of hearing. Since the fire died out recently, and the patient has become furious with the first officials, a favorable result is coming. We’ll look at how to prevent deafness in more dangerous situations.

To consolidate the effect and improve hearing during the treatment course, it is necessary to undergo physical procedures. They stimulate neurological processes and allow the body to relax.

How have you lost the deafness of the third or fourth stage? The doctor prescribes medicinal treatment, which is only before surgery. Then prosthetic replacement and implantation are carried out.

Since such methods are ineffective and the doctor does not consider the need for surgery, the patient is prescribed hearing aids. Such a situation of illness has a direct to a hearing specialist for advice and assistance in choosing a hearing device.

Visnovok

Many people with hearing loss rely on methods of non-traditional medicine. Remember that smells can only reduce symptoms, but traditional medicine cannot completely suppress or reverse hearing.

If you don’t want to risk your health, you should seek professional help.

Remember, the sooner you are diagnosed with fever, it will be easier and, perhaps, cheaper for you to treat yourself; it is not good for you to ignore signals of illness.

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Sensorineural deafness is a general concept that includes the deterioration of the neurosensory structures of the auditory analyzer, starting with the hair cells of the spiral organ and ending with the calf. This term is used instead of the term “auditory neuritis” or “cochlear neuritis”, since the smell does not completely reflect the nature and localization of the pathological process.

The social significance of sensorineural deafness is great. There are approximately 450 million individuals in the world for whom hearing impairment is one of the leading causes of disability (Wilson, 1985). Among all types of hearing impairment, less than 70% show sensorineural deafness. The number of patients with sensorineural deafness has increased due to other fatalities. Sickness dominates the middle of the productive age. The incidence of this disease is influenced by urbanization of the population, a high incidence of influenza and other infectious diseases, an increase in cardiovascular pathologies, an increase in stressful situations, and the use of ototoxic antibiotics. ticks, causing noise in the workplace and in everyday life.

Etiology

Sensorineural deafness is a more polyetiological illness. Causes of guilt are coming.

1. Infectious illnesses, especially viral ones (influenza, parainfluenza, adenoviral infection, chronic infections - brucellosis, syphilis and HIV/AIDS). The main factor affecting the hearing organ during influenza is the high vasotropicity and neurotropicity of the virus. Bacterial intoxication of the auditory analyzer structures is detected in patients with acute and chronic otitis media, serous and purulent labyrinthitis, meningitis and encephalitis of various etiologies.

2. Vascular disorders that lead to functional and organic disruption of blood circulation in the cerebral vessels, which is to revive the structures of the auditory analyzer. The smell can be associated in patients with hypertension, vegetative dystonia, cervical osteochondrosis, coagulopathy, with vascular swellings and aneurysms.

3. Toxic effects of medicinal substances on the inner ear, industrial and household extracts, and alcohol. Among ototoxic drugs, it is necessary to include antibiotics of the aminoglycoside series (monomycin, kanamycin, gentamicin, neomycin) and streptomycins (streptomycin, dehydrostreptomycin), which can penetrate through the hematolabyrinth bar and apply pathological inflow to the spiral one. Children are especially vulnerable to them. Antibiotic cream, such a pathological effect on the auditory structure can be caused by diuretics (furosemide, etacrynic acid), antitumor drugs (cisplatin, lisonidazole), similar salicylic acids, spasmoneuralgin, quinine, spironolactone (veroshpiron).

4. Traumatic care following traumatic brain injury (basal skull fracture), sudden impact of atmospheric pressure (barotrauma), intense sound (acute trauma), care during middle-grade surgery.

5. Allergic and autoimmune diseases. Autoimmune sensorineural deafness is also seen as an independent nosological form, for which the immunopathological process is surrounded by a hematolabyrinth barrier.

6. Secular changes (presbycusis), in which involutional changes in the auditory analyzer are determined by the type of output atrophy of the nerve-receptor apparatus.

7. Swelling of the cerebellopontine cerebrum (neurinoma VITT of the cranial nerves), as well as a new development of the middle ear and cerebrum.

8. Decline in illness and congenital development.

9. Professional factors (noise dullness).

10. Understanding of many predictive factors (combined dullness).

This diversity of etiological factors may lead to a lesser underlying pathogenesis, which is based on impaired microcirculation, which leads to a deficiency of sourness, vital fluids, ionic and acid-base imbalance on other no hearing analyzer. In most patients, the process is localized in the heel receptor apparatus, most often in the area of ​​the main helix.

This place is associated with the absorption of high-frequency sounds, which is pathognomonic for sensorineural deafness. Numerical experimental studies have demonstrated the role of stria vascularis, which controls endolymphatic storage, in the pathogenesis of sensorineural deafness. It is important that disruption of the ion balance of endolymph (reduced concentration of K and increased concentration of Na) leads to changes in receptor cells. Then the process can progress beyond the above mentioned etiologist This is an important factor from the learning before the processes of growth of the structures of the auditory analyzer.

At this time, the topical diagnosis of sensorineural deafness is still incomplete, but practical medicine sees two types of perceptual deafness. Peripheral (labyrinthine, cochlear, renal) deafness is caused by damage to the sensory epithelium of the spiral organ) Central (retrocochlear, retro-labyrinthine) deafness is caused by damage to the conductive nerve pathways of the auditory analyzer or clitis of the auditory zone of the measles of the cerebellum (from.

There are acute symptoms (the period of guilt lasts for many years to many days) and chronic (the pathological process lasts for more than 2 days before the onset of illness) sensorineural deafness. Rapt deafness is also seen as a particularly difficult hearing impairment, which is caused by the stretch of many nerves.

Clinical picture

Basically, there are three groups of scars: 1-a - loss of hearing in one or ear injury, either progressively or progressively and does not tend to periodically improve or decrease (fluctuation), disruption of the orientation dzherela sound, subjective noise in a damaged person varying frequency and intensity, mostly steady; 2nd - as a result of the process of the vestibular part of the labyrinth and the anterior-brain nerve, damage to the nervous system and confusion arise - so-called vestibular disorders; 3rd - zagalnosomatic skargi. These include headache, noise in the head, loss of memory, loss of productivity, and insomnia.

After an hour of otorhinolaryngological examination, the side of the ENT organs cannot be seen. Why do you say to the driver every now and then: the doctor doesn’t know anything, and the sick person doesn’t sense anything.

Diagnostic methods for investigating patients with sensorineural deafness can be divided into different groups.

1st group - audiological. Investigations of auditory function begin from the importance of hearing acuity for whispering and speaking. In this case, respect is given to the difference between the combined sounds of whispered and common speech; The great difference between them indicates a defect in sound perception. For tuning forks, follow the traces of Rinne, Federici, Bint, Weber, which allow you to differentiate the effects of the sound-receiving apparatus from impaired sound conduction.

Current audiological research methods widely used include tonal threshold and suprathreshold audiometry, local audiometry, sensitivity to ultrasound, and audiometry in a wide frequency range. Investigations are carried out using a clinical audiometer using a wireless telephone and a dial telephone.

The tonal audiometric curve in patients with sensorineural deafness usually has an empty or steeply low configuration with a maximum decrease in auditory sensitivity in the high-frequency region in both the brain and bone tissues no sound, without a brush-powder interval (div. Fig. 11). 6). In some cases, a waveform or a characteristic Carhart wave is detected at frequencies of 4-6 kHz.

To clarify the level of performance of the auditory analyzer, the values ​​of the differential sound intensity threshold (DPS) and the index of small increases in sound intensity (SISI-test) are tested to identify the phenomenon of accelerated increase in intensity (AFIG). If the FUNG is positive (change in the differential thresholds of the SISI test by more than 60-80%), we can talk about the disruption of the function of the sound-receiving elements (hair cells) of the inner ear.

For damage to the sound-receiving device, there is a characteristic increase in speech agility beyond the singing level (i.e., not reaching 100%) at any given intensity, and this gives rise to the phenomenon of a paradoxical decrease in speech agility over time. Increase in sound intensity during the course of audiometry. Early signs of sensorineural deafness can be detected within an hour of audiometry at frequencies of 10, 12, 14, 16, 18 kHz (in the extended range) and with significant sensitivity to ultrasound (96 kHz), which is of great importance for control I will become known to people who have known There is no harm in noise in the production industry, as well as in children's practice.

Of greater importance are the names of objective methods of monitoring hearing, such as impedance measurements, recording of auditory evocation potentials, and monitoring of otoacoustic emia. The two remaining methods are based on the scientific-investigative method.

The first one is simple and widely used in clinical practice to establish the presence of a conductive component in patients with mixed deafness. In patients with sensorineural deafness, the tympanometric curve does not differ from the normal one, the acoustic reflex shows little movement or is within the normal range. Vicoristic metering is also used as an objective method for identifying FUNG.

2nd group - vestibulometric methods - cupulometry with threshold and suprathreshold stimuli, bithermal calorization, tracking of optokinetic nystagmus, registration of vestibular evocation potentials.

3rd - from neurological investigation of olfactory and savory sensitivity, corneal reflex, spontaneous nystagmus.

4th - biochemical, rheological, coagulation blood testing, as well as testing of immunological indicators.

5th - treatment of blood circulation in the brain and functional activity (REG, ECOEG, Dopplerography).

6th - X-ray examination of the cervical ridge, skull, carpal bones according to Stsnverse, as well as CT and MRI.

These groups of methods for studying hearing have the status of supplementary and are aimed at identifying the causes of sensorineural deafness, which may mean the use of etiopathogenetic treatment. In some sick people, with a clear picture of illness, you can wear less stitches. It should be noted that it is often difficult to determine the cause of sensorineural deafness from any current methods of investigation (idiopathic sensorineural deafness).

D.I. Zabolotny, Yu.V. Mitin, S.B. Bezshapkovy, Yu.V. Virgo

Diseases of the auditory nerve and nerve cells of the inner ear lead to disruption of the nerve impulse from the inner ear to the brain. The patient develops illness, which manifests itself in those with hearing impairment – ​​sensorineural deafness.

The illness progresses over time, reaching the 4th stage. The cause of hearing loss is deafness, and there is a risk of changes in the vestibular apparatus. The patient experiences confusion in the head, loss of coordination, vomiting and boredom.

Treatment of neurosensory deafness 1st stage

The method of reveling is refreshing the hearing. And the earlier diagnosis and therapeutic approaches are carried out, the greater the patient’s chances of successfully overcoming sensorineural deafness. It is important to begin treatment already at the 1st stage of the disease.

At the early stages of raptovo vinyl gostra deafness, you can not only slow down the process, but often revive your hearing. Drug therapy gives good results. The sick person is recommended to receive hospital care, adjust the sound regime, sleep, rational food, and rest. Obov'yazkova's mental deterioration in hearing is related to chicken and alcohol.

Drug therapy

The drugs are not to blame for being ototoxic and harmful to hearing. For the treatment of sensorineural deafness, the following medicinal methods are prescribed:

  • antispasmodics – papaverine, drotaverine;
  • diuretics – veroshpiron, hypothiazide;
  • antibacterial drugs;

Drotaverine - one of the drugs for illness, stage 1

  • antihistamines – suprastin, tavegil;
  • anti-intoxication treatments for the body – reopolyglucin, hemodez;
  • preparations for cerebral blood flow – Cavinton, Trental;
  • vitamins B1 and B6, PP;
  • fibrinolytics - streptokinase in the presence of NaCl internally.

The drugs drotaverine and papaverine are used to improve blood circulation, reduce spasms of the blood vessels of the head, internal and middle ears. The price of drugs is 30 rubles for 40 tablets.

Verospiron and hypothiazide remove excess fluid from the body, thereby reducing intracranial pressure and normalizing pressure in the middle of the labyrinth. A package of veroshpiron containing 20 tablets costs more than 100 rubles. The price of hypothiazide is approximately 100 rubles.

When choosing antibiotics, it is important to select drugs that do not cause ototoxic effects that cause hearing loss. In case of sensorineural deafness, streptomycin, kanamycin, neomycin are not prescribed.

Cavinton and trental regulate blood flow in the brain. Trental is prescribed for the scheme, increasing dosage. Price for 60 tablets – no more than 400 rubles. Cavinton is sold in dark glass ampoules, the price of 10 pieces does not exceed 310 rubles.

What is even more expensive is streptokinase, which contributes to the process of thrombus formation and reduces thinned blood. The cost of the drug is 2200 to 2800 rubles.

Physiotherapy

Methods Number of sessions Trivalism of the day triviality
Electrical stimulation 10 30-50 hvilin 15-20 days
Air blowing + + +
Pneumomassage + + +
Hyperbaric oxygenation + + +

Acute forms of sensorineural deafness (no more than a month before the onset of illness) should undergo additional surgery.

Surgical delivery

Before surgery, transtymponal administration of dexamethasone is given in case of particularly painful ear noise. Under local anesthesia, with the help of an injection, the head is penetrated through the eardrum in the inner ear, and dexamethasone is then injected. The sick man is guilty of 20 times of trimming his head in a singing manner and not robbing the forge's hands.

Treatment of neurosensory deafness 2nd stage

Drug therapy

In case of mild deafness, the 2nd stage is added to the scheme described with the addition of a drug that overcomes hearing loss - idebenone. The drug is a low-molecular organic antioxidant that quickly penetrates the brain. To enhance brain stimulation, idebenone is taken together with vitamin E. The price of 60 capsules of idebenone is 410 rubles.

Idebenone - a drug for the treatment of deafness, stage 2

Physiotherapy

At stage 2, sensorineural deafness is treated with physiotherapeutic procedures. A positive influx on the sick man's body looms:

  1. Holcoreflexotherapy;
  2. electroacupuncture;
  3. microchvilian reflexotherapy;
  4. oxygen barotherapy;
  5. Endaural phonophoresis.

Hearing aid

With sensorineural deafness, the perception of high-frequency sounds is immediately impaired. For those with hearing aids in the 3rd and 2nd stages of illness, there is a vibrational increase in high frequencies. Due to the miniature dimensions of the device, an acoustic effect occurs, when the sound is increased, the sound is turned into the microphone. In addition, there is a possible effect of supernatural enhancement of low frequencies, which creates discomfort for the patient.

Classification of hearing aids

Hearing aids can only be installed in one ear - so choose the ones that are easier to hear, or it may hurt with bilateral deafness.

  1. Behind the signal processing method
    Analog and digital hearing aids are on sale. Today's analogue devices are differentiated from their predecessors, which are unable to produce sound. Analog devices have begun to regulate volume, timbre, number of channels, and programming capabilities. External, internal, external models are divided, the product range is 3000 - 5500 rubles.
    The digital device processes the signal through the computer's bandwidth. With such a device, patients can clearly distinguish sounds, do not feel discomfort, and easily adapt to success. Prices for digital hearing aids start from 6,200 rubles (Siemens) to 60,000 rubles (Widex).
  2. For the placement method:
    • Earmuffs – located behind the ear, supplemented with an inner ear liner;
    • internal ones – installed at the ear canal, prepared individually.

Treatment of neurosensory deafness 3rd and 4th stage

At stage 3, deafness cannot be treated with medications or physical therapy. The sick person rejoices in hearing aids and cochlear implantation.

The indications before implantation are chronic sensorineural deafness, which cannot be corrected with a hearing aid. The implant is folded with a clamp - which is installed behind the ear to convert mechanical to electrical. An additional platinum thread is used to connect the auditory nerve, through which electrical signals are transmitted to the cerebrum.

To analyze the encoding of signals, a brain processor is installed behind the ear, similar in appearance to a hearing aid. The implant is installed once, the device is used without replacing the entire life. The cost of the operation is 1,300,000 rubles; for residents of the Russian Federation, the implant can be installed at no cost.

Surgical delivery

Before surgery, treatment is limited to extreme cases. There are also operations involving resection of the tympanic plexus, removal of nerve nodes - the upper cervical and cervical.

The diagnosis of deafness occurs in patients with less severe hearing impairment, which does not go away on its own and requires treatment. In modern medicine, there is a classification of deafness into three main types: conductive, neurosensory and mixed. In addition, the disease is divided into dormant, congenital and nascent stages, and there are 4 stages.

What kind of illness is this?

However, sometimes sensorineural deafness also occurs – what are the main symptoms? The diagnosis of sensorineural deafness is synonymous with neurosensory deafness, which is made in the event that the patient has impaired perception of sound that reaches the auditory canal through the organs of the inner ear, the auditory nerve or the part of the brain It is for sound perception.

During acute illness, hearing decreases sharply. If the illness develops gradually, then the first signs of hearing loss may not be noticed. This disease begins to progress and its skin symptoms become more noticeable:

  • decreased hearing threshold;
  • periodic ringing and noise at the horns;
  • parts are dirty;
  • the foldability of the preserved ripple.

Only a doctor can make an accurate diagnosis and correctly determine the stage of illness, until at the first manifestation of a sign of illness it is necessary to stop immediately.

From an outside perspective, the doctor will perform a series of tests. Additional audiograms indicate improved hearing. The Weber test helps to determine whether the ear is more sensitive to hearing, unilateral or bilateral sensorineural deafness. And the Rinne test measures the magnitude of the permeability and bone conductivity to sound.

It depends on what stage the illness is at and what has caused the development of sensorineural deafness, treatment is prescribed on an outpatient basis or the patient is admitted to a hospital.

Reasons for rejoicing

Treatment of sensorineural deafness is a common cause of illness. Not all types are amenable to drug therapy. Most often, the only way out is an operation. Therefore, correct diagnosis at the first stage of treatment allows you to determine how much hearing can be restored, even if frequently. Let's take a look at the report on the types of illness.

Stages of illness

Successful treatment will also remain below the level of deafness. With the mildest first, if the hearing threshold decreases to 25-40 dB, the hearing often begins to deteriorate. In most patients, the first symptoms are deprived of attention and are treated with additional help only if the illness has reached another stage, if sensitivity to hearing is reduced to 40-55 dB. When the patient:

  • understands the whispers from nearby;
  • clearly senses the wash from 4-5 meters;
  • Mayzhe does not catch quiet sounds: the rustle of grass, the clicking of the anniversary;
  • often hear outside noises in the ears;
  • suffers from periodic headaches.

At this stage, it is necessary to undergo outpatient treatment and a course of physical procedures: ultrasound, acupuncture therapy, electrophoresis, etc.

With sensorineural deafness stage 3, the symptoms continue to worsen, the auditory threshold drops to 55-70 dB, and the illness becomes even worse. Confusion is often accompanied by vomiting, the noise in the ears is steady and strong. It is easy for a sick person to lose the ability to speak in a vertical position and separate words from a distance of 1-3 meters.

If stage 3 deafness does not respond to treatment, and hearing does not improve, nutrition may be disrupted for those classified as disability group 2. The most important stage of illness is stage 4, after which, with a decrease in hearing of more than 90 dB, sensorineural deafness occurs. Until this stage of illness occurs, it is only a matter of regular adequate cleansing.

It is so important for him to immediately seek qualified medical help. Remember that when diagnosing sensorineural deafness, treatment with folk methods will only give results as part of complex therapy. And then after obligatory treatment with a doctor. Otherwise, just an hour will be wasted and the illness will start.