Sensorineural hearing loss

The reasons

Symptoms of neurosensory hearing loss

Diagnostics

Treatment of sensorineural hearing loss

Forecast

Sensorineural hearing loss develops when the sensory nerve cells of the inner ear, the auditory nerve and the central formations of the auditory system are damaged.

The reasons

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In the occurrence of neurosensory hearing loss play a role:

  • infectious diseases ( flu and ORVI, mumps, syphilis );
  • vascular disorders ( hypertension, vertebrobasilar circulation , cerebral atherosclerosis);
  • stress, mechanical, acoustic and barotrauma;
  • exposure to industrial and household substances, a number of drugs ( aminoglycoside antibiotics, some antimalarial and diuretic drugs, salicylates).

Symptoms of neurosensory hearing loss

Manifestations of hearing loss consist in a decrease in hearing. Hearing loss can be combined with

  • tinnitus
  • dizziness
  • nausea
  • vomiting.

Most cases of neurosensory hearing loss occur with vestibular disorders in the presence of subjective manifestations (dizziness, incoordination, nausea or vomiting). In some cases, a violation of the vestibular function is detected only when conducting a specific neurological examination in combination with   computed tomography, magnetic resonance imaging, Doppler ultrasound and rheoencephalography.

Diagnostics

Diagnosis of neurosensory hearing loss is carried out by the ENT doctor. A modern approach to the diagnosis of hearing loss involves the study of the function of the sound-conducting and sound-receiving systems, the vestibular analyzer, the study of blood coagulation and liver function, assessment of the cardiovascular, excretory and endocrine systems, which makes it possible to establish the cause of the disease and develop the most effective treatment tactics.

In practice, the initial assessment of the auditory function requires the analysis of acoustic and audiological indicators, among which the carrying out of dial- tuning samples, the recording of a tone threshold audiogram are mandatory . An additional, more informative method to clarify the type of hearing loss is audiometry performed in the frequency range above 8000 Hz.

Inclusion in the examination plan of patients with neurosensory impedance -impairment hearing loss is a method for detecting a break in the circuit of the auditory ossicles, the presence of effusion in the tympanic cavity, and dysfunction of the auditory tube.

Treatment of sensorineural hearing loss

The treatment plan is individual for each patient, determined based on the causes and duration of the disease, the presence of concomitant diseases. However, there are general rules for the treatment of:

  • treatment of a patient with acute sensorineural hearing loss in a specialized otorhinolaryngological hospital;
  • immediate start of treatment immediately after hospitalization;
  • observance of a sparing diet;
  • quitting smoking and drinking alcohol

Taking into account the peculiarities of the disease, drugs are used to improve the blood supply to the inner ear. Such drugs as Vinpocetine , pentoxifylline , Cerebrolysin , Piracetam are used intravenously for the first 10 days, gradually increasing the dose of the drug from the 1st to the 4th day and keeping the permanent therapeutic dose from the 5th to the 10th day of treatment. Subsequently, they switch to intramuscular and tablet use of drugs, with a total duration of the first course of treatment of 1–1.5 months.

For the treatment of neurosensory hearing loss, accompanied by dizziness, drugs with a specific effect on the inner ear (for example, betahistine ) are successfully used . The drug should be taken during or after a meal to prevent a possible adverse effect on the gastric mucosa, in the absence of a patient’s stomach ulcer and   bronchial asthma.

Increases the effectiveness of drug treatment of sensorineural hearing loss and stabilizes the positive clinical dynamics of the inclusion of non-drug methods into the complex of therapeutic measures: reflexotherapy – acupuncture or laser puncture (10 sessions immediately after the completion of intravenous therapy, then 10 sessions after 1 month and, if necessary, 10 sessions after 2–3 months after the first course of inpatient treatment), as well as hyperbaric oxygenation (the duration of a session is 30 minutes, the course of treatment is 10 sessions).

Rehabilitation of hearing by implanting electrodes into a cochlea in order to electrically stimulate the fibers of the auditory nerve is becoming more common.

It should be emphasized that even adequately selected therapy of a patient with acute sensorineural hearing loss does not exclude the likelihood of disease recurrence under the influence of a stressful situation, exacerbation of cardiovascular disease, acute viral infection or acoustic trauma.

To eliminate tinnitus: Sit on a chair with the head tilted 30 ° forward and upside down, eyes closed. Close your ears tightly with your palms and press them to the temples, placing your fingers on the occipital region. With the tip of the middle finger of your right hand, make 60 rhythmic tapping on the middle finger of your left hand.

Forecast

With adequate treatment and compliance with preventive measures (stopping smoking, taking alcohol and drugs, sufficient physical activity, the ability to overcome episodes of neuropsychiatric stress and stressful situations) – the prognosis is favorable.

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