Bilateral chronic sensorineural hearing loss 1st degree massage. Sensorineural hearing loss - causes and treatment. Methods for treating acute forms of the disease

Weakening of a person's hearing function is called hearing loss. The main difference between this disease and deafness is partial rather than complete hearing loss. Sensorineural hearing loss is considered one of the forms of hearing impairment, the main cause of which is damage to one or another part of the sound-receiving section of the auditory analyzer.

Features of the disease

According to the definition, sensorineural hearing loss (synonym - sensorineural hearing loss) is a non-infectious disease accompanied by impaired functioning of the hearing organs. It is associated with damage to the brain structures responsible for hearing, as well as pathology of the inner ear and vestibulocochlear nerve.

The classification of hearing loss includes the following degrees:

Easy - a person hears well when sounds come from a source located at a distance of up to 4-6 meters. The hearing threshold for sounds with a frequency of 500-4000 Hz exceeds the norm by 50 dB.
Average - spoken speech is heard by the patient only at a distance of 1-4 meters, the hearing threshold is increased by 41-55 dB in the above sound frequency range.
Heavy - speech can be heard by a person from a distance of no more than 1 meter. The hearing threshold of the same range is 60-70 dB higher than normal.
Deep - the threshold of speech audibility is increased to 70-90 dB, sounds are audible to a person only when they are produced at the closest distance to him.

If the hearing loss further exceeds the indicated indicators, the diagnosis is not sensorineural hearing loss, but deafness.

Among other things, sensorineural hearing loss is differentiated according to the duration of its existence into the following forms:

acute - its symptoms increase over several days, maximum - up to 4 weeks;
chronic - develops slowly, but does not progress steadily. Complete restoration of hearing in this form of the disease is almost impossible;
sudden - occurs no more than a day in advance, most often starts in a dream.

Depending on the type of damage to the auditory analyzer, sensorineural hearing loss can be associated with pathology of the structures of the inner ear (hearing loss of peripheral origin) or the brain stem and cortex (hearing loss of central origin).

The disease can occur in any age group, but it mainly affects the elderly part of the population, since with age there is a natural decrease in hearing function (presbycusis). Severe hearing loss is observed in 1.6% of the population, and the total proportion of hearing impairment, including mild hearing impairment, reaches 6%. In children, sensorineural hearing loss reaches 0.5%, and a significant proportion of them have suffered severe infectious diseases in the past (for example, meningitis).

Causes of pathology

It is not always possible to accurately determine the causes of sensorineural hearing loss, since there can be many of them, and in a particular clinical case, sometimes more than one factor is involved. But most often in middle-aged people and children, pathology develops after an infectious disease:

flu;
pigs;
syphilis;
mumps;
purulent otitis;
meningitis;
labyrinthitis;
toxoplasmosis.

In addition, the causes of pathology are often vascular and nervous diseases that lead to dysfunction of the hearing aid - atherosclerosis, hypertension, VSD. It is also possible that hearing loss may occur after a strong nervous shock, damage to the head or ear, or being close to a source of powerful sound. Some people experience a pathological reaction of the body in the form of partial hearing loss while taking certain medications or after toxic poisoning and exposure to industrial pollutants or radiation.

Less common causes of hearing loss may include:

allergic diseases;
Paget's disease;
some autoimmune diseases;
alcoholism, drug addiction.

If the exact causes of the pathology are not identified, the person is considered to have idiopathic sensorineural hearing loss. In most cases, this disease develops in young people, and sometimes it progresses steadily and cannot be treated. It is worth noting age-related hearing loss (presbycusis), which always evenly affects both hearing organs, as well as congenital hearing loss (its causes are most often associated with birth pathology, fetal hypoxia, neonatal sepsis or hereditary diseases). It has been noted that hearing impairment more often occurs in people whose relatives have similar problems, as well as in people with abnormalities in the structure of the hearing organs and reduced immunity.

Symptoms of sensorineural hearing loss

The acute form of the disease often occurs after an infection or stress, or develops against their background. The leading symptom of the pathology is a decrease in auditory function, when a person ceases to hear as clearly as before, and one or both ears may be involved in the pathological process. Other possible components of the clinical picture of sensorineural hearing loss:

noise, buzzing in the ears;
transient feeling of stuffiness in the ears;
squeaking, ringing in the ears.

Such symptoms may increase during the day or remain unchanged, and may gradually subside. The discomfort felt by a person can be quite strong, as a result of which he begins to suffer from insomnia, disorders of the vestibular apparatus, and dizziness are observed. If the form of the disease is sudden, then hearing loss develops in less than a day, forcing the patient to experience very painful feelings, and can result in severe hearing loss. However, treatment for sudden sensorineural hearing loss is usually successful and the prognosis is favorable.

The least good prognosis is for the chronic form of the disease, in which symptoms increase gradually and hearing loss is persistent and steady. Noise, humming, ringing in the ears with this form of pathology increases over several years, and most often this is the only unpleasant sign that forces a person to see a doctor. Lack of timely medical care for any type of sensorineural hearing loss is a potential risk of complete hearing loss and the development of irreversible deafness, so any pathological symptoms should prompt a person to visit a specialist.

Methods for diagnosing hearing loss

The main way to diagnose sensorineural hearing loss is an audiogram, or identifying the ability of the hearing aid to perceive sounds based on their volume. It is this examination method that allows you to determine the degree of impairment of auditory function and the severity of hearing loss with an accuracy of 100%. But after establishing the authenticity of the disease and its degree, the cause of sensorineural hearing loss should be found, for which other examination methods are prescribed:

bacterial culture tests, serological tests, ELISA, PCR diagnostics if the infectious nature of hearing loss is suspected;
CT, radiography, MRI for the diagnosis of tumor formations of the ear and auditory nerve;
rheoencephalography, Doppler, cardiointervalography, EEG, EchoEG, neurosonography in children and other methods for detecting vascular disorders;
examination by an ophthalmologist to detect intracranial hypertension;
pure tone and computer audiometry.

When hearing loss is detected in a newborn, it is important to conduct a full diagnosis of genetic abnormalities in order to promptly begin correction and treatment of these pathologies.

Treatment methods for hearing loss

As already mentioned, only a sudden and acute form of sensorineural hearing loss is best treated and can most likely result in complete restoration of hearing. Typically, acute sensorineural hearing loss should be treated in a hospital in order to apply the entire range of necessary measures and procedures to the patient, and in the case of a sudden form of the disease, hospitalization should be emergency. In case of a chronic type of pathology, it is important to stop or slow down the process of hearing loss, even if, due to partial death of the nervous tissue, it is impossible to completely restore the function of the auditory analyzer. Experts say that the conditions for successful treatment are early initiation of therapy, timely elimination of its cause and selection of the correct treatment methods.

Drug therapy for the disease may include:

drugs to improve cerebral blood flow, nootropics, vasodilators - Actovegin, Trental, Piracetam, Lucetam, Nootropil, Tanakan. Medicines can be administered intravenously or directly into the inner ear through a shunt in the eardrum;
B vitamins, especially thiamine, pyridoxine, as well as vitamin E, magnesium to improve nerve conduction;
FiBS, ATP, aloe and other biogenic stimulants to improve tissue metabolism;
glucocorticosteroids (Prednisolone, Hydrocortisone) to normalize the trophic function of blood vessels and correct blood flow in the inner ear;
antihistamines against tissue edema - Suprastin, Desloratadine, Diazolin;
diuretics and other decongestants, antispasmodics, antihypoxants, sedatives and other drugs as indicated.

Non-drug treatments for hearing loss may include hyperbaric oxygen therapy in the form of inpatient courses, physical therapy to influence the inner ear (magnetic therapy, helium-neon laser, microcurrent reflexology). Complex treatment of sudden and acute hearing loss gives excellent results - up to 70-90% of cure, but in the chronic form of the disease this figure does not exceed 20-30%. Patients are often offered the installation of a hearing aid, which will improve their hearing performance. Almost all children with hearing loss are recommended for training and rehabilitation programs under the supervision of an audiologist.

If it is possible to restore hearing and there are indications, surgical intervention is performed - cochlear implantation (hearing replacement of the cochlea of the inner ear). The patient is fitted with an implant, which will be responsible for the perception of sounds and their transmission to the brain. Nowadays, this type of operation has already helped many people with congenital or acquired hearing loss to hear again. In addition, for hearing loss, operations are practiced to create collateral blood circulation in the inner ear by bringing a branch of the cervical artery to it (stapedoplasty).

Therapy with folk remedies

Treatment of pathology with folk remedies will be a good addition to conservative therapy, since it is aimed at improving nerve conduction and the condition of the blood vessels of the brain and inner ear. Popular methods against sensorineural hearing loss are the following methods of alternative therapy:

Pour hot water (300 ml) into a mixture of a tablespoon of crushed cranberries and the same amount of lingonberries. Leave for half an hour, add honey to taste, drink, and eat the berries. Repeat once a day for 1-2 months.
Grind the garlic (clove) in a garlic press, combine 1:3 with olive oil. Place 2 drops in the ears once a day for 20 days.
Crush several viburnum berries, squeeze out the juice, combine with an equal amount of honey. Soak cotton pads in the product and place them in your ears overnight. The course of treatment is 20 procedures.
Brew 5 bay leaves with a glass of boiling water and leave in a thermos for 3 hours. Drink a spoon three times a day on an empty stomach, and also drop 4 drops into your ears at night. Repeat treatment for a month.
Buy almond oil and put 5 drops in your ears before bed.
Brew a tablespoon of string in a glass of boiling water and leave for 3 hours. Drink a glass of the product twice a day for 20 days, repeat the course a week later.

Disease prevention

To prevent problems from arising, you need to treat any infectious diseases in a timely manner, especially those affecting the ears. For chronic otitis media, it is important to register with an otolaryngologist and systematically carry out preventive courses for the hearing organs. Pregnant women, in order to avoid hearing disorders in the fetus, are required to minimize the influence of any teratogenic factors, including x-ray exposure, radiation, drugs, alcohol, etc.

In addition, to prevent the development of hearing loss, it is important to regularly perform medical examinations of the hearing organs in children, immediately remove foreign bodies that have entered the ear, and treat head and ear injuries under medical supervision. In all age categories of people, it is necessary to adequately eliminate or correct all chronic pathologies of the ENT organs, to prevent the harmful effects of poisoning, pollution in production conditions, smoking, alcohol and other factors on the ears.

And finally, in the next video you will learn how sensorineural hearing loss is treated with an implant.

The diagnosis of hearing loss is made to patients with more or less serious hearing damage, which does not go away on its own and requires treatment. In modern medicine, there is a classification of hearing loss into three main types: conductive, sensorineural and mixed. In addition, the disease is divided into hereditary, congenital and acquired and has 4 stages.

What kind of disease is this?

But sometimes sensorineural hearing loss also occurs - what is it and what are its main symptoms? The diagnosis of sensorineural hearing loss is synonymous with sensorineural hearing loss, which is made when the patient has impaired perception of sound entering the auditory canal due to damage to the organs of the inner ear, the auditory nerve, or the part of the brain responsible for sound perception.

In the acute course of the disease, hearing decreases sharply. But when the disease develops gradually, the first signs of hearing loss may not be noticed. Then the disease begins to progress and its symptoms become more noticeable every week:

decreased hearing threshold;
periodic ringing or noise in the ears;
frequent dizziness;
difficulty maintaining balance.

Only a doctor can make an accurate diagnosis and correctly establish the stage of the disease; at the first signs of the disease, you should contact him immediately.

In addition to an external examination of the ear, the doctor does a number of tests. Using an audiogram, the degree of hearing damage is determined. The Weber test helps determine which ear hears better, whether unilateral or bilateral sensorineural hearing loss is present. And the Rinne test determines the magnitude of air and bone conduction of sound.

Depending on the stage of the disease and what caused the development of sensorineural hearing loss, treatment is prescribed on an outpatient basis, or the patient is admitted to a hospital.

Causes and treatment

Treatment of sensorineural hearing loss directly depends on the type and causes of the disease. Not all of its types are amenable to drug therapy. Often the only option is surgery. Therefore, correct diagnosis at the first stage of treatment allows us to determine how possible it is to restore hearing, at least partially. Let's take a closer look at the types of disease.

Stages of the disease

The success of treatment also greatly depends on the degree of hearing loss. With the mildest, first, when the hearing threshold is reduced to 25-40 dB, hearing can often be saved. But most patients ignore the first symptoms and seek help only when the disease has reached the second stage, at which hearing sensitivity is reduced to 40-55 dB. In this case, the patient:

understands whispers only from close range;
clearly hears speech from 4-5 meters;
almost does not pick up quiet sounds: the rustling of grass, the ticking of a clock;
often hears extraneous noises in the ears;
suffers from periodic dizziness.

At this stage, outpatient treatment is usually prescribed and a course of physiotherapy is carried out: ultrasound, acupuncture therapy, electrophoresis, etc.

With sensorineural hearing loss of degree 3, the symptoms continue to intensify, the hearing threshold drops to 55-70 dB, and the disease manifests itself even more clearly. Dizziness is often accompanied by vomiting, and the tinnitus is constant and severe. It is difficult for the patient to remain upright and distinguish words spoken from a distance of more than 1-3 meters.

If grade 3 hearing loss cannot be treated and hearing does not improve, the question of assigning disability group 2 can be raised. The most severe stage of the disease is stage 4, after which, with a hearing loss of more than 90 dB, sensorineural deafness occurs. The acquired disease reaches this stage only in the absence of regular adequate treatment.

Therefore, it is so important to seek qualified medical help in a timely manner. Remember that when diagnosed with sensorineural hearing loss, treatment with folk remedies will only give results if used as part of complex therapy. And then after mandatory agreement with the attending physician. Otherwise, time will only be wasted and the disease will develop.

Such a problem as hearing loss has recently become very relevant, since more and more people are affected by it, regardless of age. Quite often, this defect leads to complete deafness if such a problem is not identified in time. And in order to avoid complete hearing loss, it is necessary to find out what causes this disease and how to recognize it in a timely manner.

Description of the disease

What is sensorineural hearing loss?

When a person experiences hearing loss that makes it difficult to hear what someone is saying at an average or relatively short distance, this condition is called hearing loss.

Quite often, a person suffering from such a defect is unable to understand someone else’s whisper addressed to him. This also applies to those cases when the person calling speaks in a loud voice, but the patient still cannot distinguish and understand what is being said to him.

The examples described above are the first manifestation of a disease such as hearing loss. It is also worth noting that at the moment this defect is getting younger and progressing. Since newborn children, young people and the elderly are increasingly exposed to it.

How does hearing loss develop?

Sensorineural hearing loss is classified according to the duration of its so-called existence into the following forms:

Acute form, progressing over several days and up to two weeks.

Chronic sensorineural hearing loss develops quite slowly, but progresses greatly. It is worth emphasizing that with this form of the disease it is almost impossible to restore hearing.

The sudden form, appearing in less than a day, most often occurs during sleep.

Based on the form of damage to the hearing system, sensorineural hearing loss is often associated with a defect in the structure of the inner ear.

As described above, such a defect can affect any person, but most often it affects older people. Because mainly with age comes a natural decline in hearing function.

Why does this defect appear?

Unfortunately, it is not always possible to identify what caused this disease. The thing is that there are quite a lot of reasons why sensorineural hearing loss appears, and often several culprits provoke such a defect.

But, nevertheless, experts have identified several main reasons due to which this disease develops, namely:

from previous influenza;

after mumps;

after syphilis;

from mumps;

after purulent otitis;

after meningitis;

after labyrinthitis;

after toxoplasmosis.

In addition to the diseases described above, hearing loss can often be caused by vascular and nerve defects that cause disruptions in the functioning of the hearing aid.

Also, cases have now been registered in which hearing loss appeared as a result of severe stress or head injury. And in some people, such a defect appears as a reaction of the body to taking certain medications.

Less common causes

It is worth noting that there are also less common factors that can also provoke this disease, namely:

allergic diseases;

with Paget's defect;

when a tumor forms in the auditory nerve;

for alcoholism and drug addiction.

In the case where the culprit that provoked this disease has not been identified, the specialist designates such a defect as idiopathic acute sensorineural hearing loss. Unfortunately, the vast majority of such diagnoses are made to young people. Moreover, the danger lies in the fact that this type of defect progresses quite quickly and cannot be treated.

And if hearing loss manifests itself in an elderly person, then the defect evenly attacks both ears. This rule also applies to congenital illnesses that occur as a result of sepsis and fetal hypoxia. This is bilateral sensorineural hearing loss.

First signs of manifestation

In the overwhelming majority, the acute form of a defect such as sensorineural hearing loss is the result of an infection or a stressful situation. The very first and main sign of the emerging disease is a noticeable decrease in hearing in a person. In other words, the patient ceases to clearly hear the interlocutor. And quite often both ears take part in such a defective process.

As for other signs of an emerging defect, there are several of them, namely:

constant noise or buzzing in the ears;

feeling of stuffiness in the ears;

The above symptoms mainly appear during the day and do not disappear until the next morning. Sometimes, on the contrary, such signs appear and then disappear. Moreover, such unpleasant sensations can be quite strong, which is why a person cannot fully rest at night, and in some cases, insomnia may develop.

In cases where hearing loss develops rapidly, a person experiences very unpleasant sensations, and the form of the defect itself often leads to complete loss of hearing. But at the same time, getting rid of the disease is quite simple if you seek help in a timely manner.

The best prognosis for treatment is the chronic form of this disease. With this form, symptoms appear gradually in the form of hearing loss over several years. As for the signs of the development of this defect, a person only experiences noise and buzzing in the ears.

If you do not seek help from a specialist in a timely manner, then with any type of sensorineural hearing loss there is a high probability of developing deafness that cannot be treated.

Sensorineural hearing loss: degrees

Hearing loss is dangerous because with age it can change from acute to chronic. The hearing threshold determines the degree of development of the disease. There are 4 degrees or stages.

Sensorineural hearing loss of 1st degree - audibility is reduced, but not too much. If a sound comes from a distance of a meter or two meters, then a person hears it perfectly. The words are clearly visible. But if a whisper or noise is heard from a distance of two meters, then the person can no longer make out anything. The norm is 20 dts, with hearing loss of 1 degree the threshold changes to 40 dts.

Sensorineural hearing loss of the 2nd degree - change in the hearing threshold to 55 dts. Speech is inaudible at a distance of 4 meters, whispering is inaudible at a distance of 1 meter. If there is noise around, it is impossible to make out words.

Grade 3 hearing loss - severe stage with a threshold of 70 dts. The sound is indistinguishable from a distance of 2 meters, the whisper is not audible at all.

4th degree - develops into complete deafness. More than 70 dts hearing threshold. A person cannot understand speech at a distance of more than a meter.

It is important to contact a specialist in a timely manner.

How is hearing loss diagnosed?

In the vast majority of cases, hearing loss can be diagnosed using an audiogram. Thanks to this technique, a specialist can determine the degree of hearing impairment with 100% accuracy. But after the diagnosis has been established, a prerequisite is to identify the provocateur that provoked the onset of this defect. For this purpose, the following types of examination are prescribed:

serological tests;

bacteriological culture tests;

X-ray;

MRI to identify possible tumors in the ear;

examination by an ophthalmologist;

pure tone and computer audiometry.

If hearing loss was detected in a child at birth, then a complete diagnosis of genetic abnormalities is a prerequisite. This technique is very important in order to begin treatment of this defect.

Sensorineural hearing loss: treatment

As described above, sudden and acute forms of sensorineural hearing loss respond best to treatment. And if therapy is started on time, then a person has a chance to regain his hearing completely.

As a rule, such a defect is treated in a hospital in order to apply the entire range of necessary procedures. As for the sudden form, urgent hospitalization of the patient is the most important condition in order to cope with this disease.

As for the chronic form of this disease, the most important condition for restoring hearing is timely consultation with a doctor. If you stop the process of hearing loss in time, even in the case when partial death of nerve endings occurs, there is a great chance of partially returning the most important function for a person.

When diagnosed with sensorineural hearing loss, treatment is as follows:

Use of drugs.

Non-drug treatment.

Surgical intervention in cases where the disease has advanced.

If a disease such as sensorineural hearing loss of degree 2 is detected, the person is prescribed the following medications:

drugs that improve cerebral blood flow;

vasodilator medications;

nootropic medications;

B vitamins;

biogenic stimulants;

antihistamines.

The above medications can be administered by injection either intravenously or directly into the inner ear.

Non-drug treatment

Non-drug treatments for hearing loss include the following ways to get rid of this problem:

Hyperbaric oxygenation in the form of physiotherapy courses for the effect on the inner ear. It is worth noting that this method is used only in cases where the patient is treated in a hospital.

Treatment using magnetic techniques.

Microcurrent reflexology.

Neon laser.

Using the methods described above guarantees excellent results in 90% of cases. But in order to get it, you should also use drug treatment.

If we are talking about a chronic form, then, unfortunately, these techniques can only help in 30% of cases. It is for this reason that the vast majority of patients are offered hearing aid installation.

As for children suffering from hearing loss, the course of treatment includes a mandatory period of rehabilitation, which takes place under the full supervision of an audiologist.

Operation

If there is a possibility of regaining lost hearing through surgery, then such a procedure is mandatory. The most common technique is cochlear implantation. In practice, everything looks like this: during the operation, the patient is given an implant that will help capture all the sounds of the environment and transmit them to the brain.

At the moment, such surgical intervention has helped tens of thousands of people who were diagnosed with congenital or acquired hearing loss to hear again. In addition, in modern medicine, surgical interventions have recently been increasingly practiced to create collateral circulation of the inner ear by bringing one branch of the cervical artery to this organ.

Is it possible to prevent the disease?

In order for such a defect not to disturb a person, it is necessary to take a responsible approach to the treatment of any infectious disease, especially when such a defect concerns the ears.

If a person suffers from chronic otitis media, then it is necessary to register with an otolaryngologist and carry out preventive manipulations for the hearing organs. It is worth noting that special attention should be paid to this problem for pregnant women. In order to avoid the appearance of such a defect in a child, it is necessary to minimize absolutely all tartogenic factors, this applies to x-rays and possible exposure to radiation. You can also add to this list taking medications and drinking alcohol.

In order to avoid complete hearing loss in the future, every person should undergo regular preventative examinations with a specialist. This is especially true for small children, since babies can independently insert various objects into their ears, which provoke such a problem in the future.

Sensorineural hearing loss is a general hearing loss that occurs due to a number of diseases of the inner ear, damage to the auditory nerve or one of the areas located in the brain. Hearing deterioration is observed, according to medical statistics, in an increasing number of patients every year.

Figures indicate that such diagnoses have already been given to more than 450 million people. Of all cases, sensorineural hearing loss accounts for about 70%. The dominant category of patients with this pathology are people of working age.

The increase in recorded cases of diagnosis is associated with a sharp increase in pathologies of the cardiovascular system, frequent influenza and viral infections, stressful and conflict situations, as well as work in hazardous industries.

Reasons for the development of pathology

In most cases, the development of sensorineural hearing loss is caused by damage to the sensory epithelial, that is, hair cells that line the cochlea of the inner ear, it is called the spiral (organ of Corti). Cases of illness due to damage to the cranial nerve or auditory brain centers are not common; in exceptional situations, doctors are forced to diagnose damage to the central auditory analyzer.

Sensorineural hearing loss can be congenital or acquired, and many factors play a role in the development of the disease - these are external causes (acoustic trauma, past infections) and internal deviations, for example, defective genes that lead to deafness.

If hearing loss is accompanied by damage to the central parts of the auditory analyzer, it can be caused by prolonged listening to music, frequent stay in a noisy room, or working in hazardous industries.

Congenital factors of the disease

The causes of congenital hearing loss lie in the abnormal development of the fetus during gestation by the mother:

underdevelopment of the cochlea of the inner ear;
hearing loss accompanied by other pathological symptoms, including chromosomal defects;
hyperplasia of the squamous epithelium of the middle ear - manifested by a tumor process, which, if not treated in a timely manner, destroys the structure of the ear tissue;
alcohol syndrome - manifests itself in newborns whose mothers abused alcohol during pregnancy (due to the ototoxic effects of ethyl alcohol and insufficient supply of vitamins and microelements through the placenta);
premature birth;
chlamydial infection transmitted to the fetus through the placenta;
syphilis;
congenital rubella syndrome - it combines sensorineural deafness, heart disease and eye damage.

This form of the disease is more often diagnosed in children

Also, scientists and doctors, through numerous studies, have proven that sensorineural hearing loss and deafness can be hereditary. If one of the parents has an autosomal gene, the probability of developing hearing pathology in the offspring reaches 50%.

Acquired etiology

Sensorineural hearing loss syndrome can also be acquired during life and is caused by various injuries, diseases and adverse effects of medications, ecology in the living and working environment. The main factors contributing to the development of acquired sensorineural hearing loss:

Acoustic and mechanical injuries. Acoustic damage to the hearing aid is provoked by exposure to too loud music or noise, the level of which exceeds 90 dB; mechanical injury occurs due to impacts, skull fractures and other accidents.
Ototoxic effects of drugs. The most dangerous are drugs from the group of aminoglycoside antibiotics, for example, Gentamicin. Reversible disorders are caused by diuretics, nonsteroidal anti-inflammatory drugs, macrolide antibiotics, and salicylates (Aspirin).
Viral infections. Acute sensorineural hearing loss can be caused by severe measles, rubella, herpes, influenza, and mumps. Patients diagnosed with HIV or AIDS often suffer from severe hearing impairment, since these infections directly affect the cochlea and the central auditory analyzer.
Bacterial infections and diseases. These include inflammation of the inner ear (purulent labyrinthitis), adenoid growths that reduce the patency of the auditory tube, as well as meningitis (inflammation of the meninges).
Immune and allergic pathologies. One of the reasons for the development of hearing loss may be chronic allergic rhinitis, which provokes frequent otitis media. Autoimmune pathologies that cause pathological changes in the structure of the cochlea include Wegener's granulomatosis (inflammation of the vessels located inside the ENT organs).
Pathological neoplasms. Tumors located in the area of the vestibulocochlear and facial nerves, acoustic neuroma and meningioma (tumor of the lining of the brain) are the direct causes of the development of sensorineural hearing loss in the patient.
Otosclerosis. With this disease, bone tissue grows around the stapes, a bone located in the cavity of the middle ear, and its immobility develops, which entails sensorineural hearing loss.

What exactly is the reason for the development of the pathology, and what stage the disease will reach - only a doctor can say after a detailed examination of the patient

At the first symptoms of hearing impairment, especially if they appeared against the background of an ongoing concomitant disease, you cannot delay a visit to the hospital - in such situations, the days count.

Forms of the disease

As already mentioned, sensorineural hearing loss can be acquired or congenital. The congenital form of the disease is divided into two types. Non-syndromic type - the pathology occurs in isolation, not accompanied by any accompanying symptoms and diseases that are inherited. The majority of cases of hearing loss (75–80%) are due to this type of disease.

Syndromic type - hearing loss is accompanied by other signs and pathologies, for example, Pendred syndrome (includes impaired auditory perception and thyroid dysfunction). This variant accounts for the remaining 25–30% of all reported cases of the disease.

The disease is also usually classified according to development options and localization. If a disorder of auditory perception is observed only on the right side, a diagnosis of right-sided sensorineural hearing loss is made; if the lesion is localized on the opposite side, a left-sided pathology is diagnosed.

The sudden form of the disease is manifested by an increase in signs of the pathological process within 12 hours - such a development of events can lead to partial or complete loss of hearing function. However, if the problem is diagnosed in a timely manner, the prognosis for hearing loss is considered favorable.

The acute form of sensorineural hearing loss differs from the sudden one in that its development does not occur so rapidly - the symptoms become pronounced within 10 days. In this case, the patient first notices some pain inside the ear, a feeling of stuffiness that appears periodically, then noise in the auricle joins the symptoms, leading to persistent hearing loss.

This form of the disease is insidious and dangerous because many patients try to delay a visit to the doctor as long as possible, and even if the disease is bilateral, they refer to the accumulation of earwax or other non-dangerous factors. Such actions often lead to disastrous results, since the success of treatment for sensorineural hearing loss directly depends on the timely diagnosis of the pathology.

The chronic form of the disease can develop over many years, with the patient periodically experiencing tinnitus and noting a mild hearing loss. Gradually increasing symptoms torment the patient, becoming permanent, and finally forcing him to seek medical help.

One of the unfavorable outcomes of ignoring the symptoms of the disease is the complete loss of hearing function and forced disability, so timely detection and treatment of pathology must be taken seriously.

Chronic hearing loss can occur in a progressive or stable stage

Degrees of hearing loss

Pathology has four degrees:

Sensorineural hearing loss 1st degree– is considered the easiest and most quickly curable form. The first degree is characterized by a hearing threshold of 26–40 dB; a person can clearly hear spoken speech if the sound source is no further than 6 meters from him. The patient hears words spoken in a whisper from a distance of 3 meters. If, in addition to human speech, there are other sound sources, then the perception process can significantly deteriorate.
Sensorineural hearing loss 2 degrees– diagnosed in patients who are able to understand speech at a distance of 4 meters from the sound source, and whispering - from 1 meter. The perception threshold in this case is 41–55 dB, and problems with the perception of sound in a patient can also arise in a normal noise environment. The second stage of the disease is diagnosed in people who constantly repeat phrases that they cannot clearly distinguish by ear.
Sensorineural hearing loss 3 degrees– characterized by the patient’s ability to understand speech addressed to him only if the opponent is 1 meter away from him, and whispers are not perceived at all. The threshold for the perception of the third degree of the disease is set at 56–70 dB, and it itself is considered severe, since it creates great difficulties in the patient’s communication with other people.
Sensorineural hearing loss grade 4– auditory function is almost completely lost, leading to the fact that the patient cannot distinguish sounds without approaching the source less than 25 centimeters. The fourth degree perception threshold is 71–90 dB, which is practically considered complete deafness.

As you can see, the fourth degree of hearing loss is the most severe of the stages of this disease. To prevent the pathology from progressing to such an advanced stage, it is necessary to resolve the issue of possible treatment in a timely manner.

Symptoms and diagnosis

In order to prevent the disastrous consequences of acquired sensorineural hearing loss, you need to know its main symptoms, noticing which you should immediately contact an ENT doctor: hearing loss on one or both sides at once, which increases gradually or develops suddenly, tinnitus, dizziness, nausea, up to the gag reflex, loss of coordination and orientation in space.

If you suspect a pathology on the part of the hearing organs, you must take the problem seriously

An immediate trip to the hospital is recommended for those patients who suffer from regular occurrence of tinnitus, who notice that they often repeat questions to the interlocutor, who feel that the speech of the people around them is unintelligible and quiet, and also watch TV or listen to music at high volumes. The situation is aggravated if a person experiences discharge from the external ear canal or takes medications that have a toxic effect on the hearing aid.

When contacting an otolaryngologist, the doctor begins the examination with a detailed interview of the patient, finds out the nature of the disorders, whether there is tinnitus, pain, vomiting, dizziness. Then the doctor finds out whether the patient has recently suffered any infectious pathologies, taken toxic drugs, or experienced ear injuries. All these data can more accurately establish the preliminary clinical picture.

An initial examination is then carried out, which may not detect any visible changes in the membrane and ear canal. For a more accurate diagnosis, audiometry is performed (it can be speech, computer, tone), tuning fork examination, MRI using a contrast agent, and examination of the blood vessels of the brain and neck. Other examination methods are prescribed according to indications.

Drug treatment

Acute sensorineural hearing loss requires immediate hospitalization of the patient and rapid selection of appropriate treatment tactics. During therapy, the following groups of drugs are used:

reducing pressure in the inner ear;
improving blood circulation;
eliminating venous congestion;
improving metabolic processes in nerve cells.

The first stage of treatment can last up to three months; upon completion, the patient is re-examined to determine whether there are visible improvements in his health.

The second stage of therapy involves the use of drugs that improve blood circulation in tissues, vascular group agents, metabolic stimulants and vitamin complexes. Physiotherapeutic procedures are also indicated for the patient.

If drug treatment for sensorineural hearing loss produces positive results, and dynamic improvements are confirmed by hardware studies, the doctor prescribes a comprehensive treatment designed to prevent relapse and progression of the disease.

The patient is also given recommendations to avoid factors that can provoke a re-exacerbation of the disease - this is avoidance of toxic medications, prevention of infections, timely treatment of chronic pathologies. Maintenance therapy for patients after treatment is prescribed every six months; it consists of undergoing courses of physiotherapeutic treatment, acupuncture and preventive drug treatment.

Hearing aids

The use of a hearing aid or other device that facilitates the patient’s perception of sound is used for sensorineural hearing loss that cannot be treated with conservative (medicinal) methods of therapy.

Contraindications for hearing aids are considered to be disturbances in the functioning of the vestibular apparatus, acute inflammatory processes occurring in any part of the ear, as well as the rehabilitation period after meningitis or surgical hearing-improving intervention.

This is what one of the hearing aid models looks like

A hearing aid is a portable electroacoustic device that amplifies the received and converted sound signal; it consists of several parts. This is a microphone that receives and converts sound, an electronic amplifier, a power source and a telephone.

The latter can be bone, that is, transmit sound information through the bones of the skull directly to the inner ear, and airborne, that is, transmit a signal through the external auditory canal. The choice of model depends on the indications and preferences of the patient - the device can be in-ear, behind-the-ear or pocket-sized.

A cochlear implant is a special medical device that allows patients with severe sensorineural hearing loss to be compensated for the complete loss of hearing function. The main indication for implant installation is considered to be bilateral sensorineural deafness, accompanied by the inability to recognize spoken speech, even with selected hearing aids.

Cochlear implantation will not be effective if hearing loss is not due to the death of hair cells in the cochlea, but as a result of damage to the auditory nerve or analyzer located in the stem and temporal part of the brain. Also, the implant will be useless if there is a deposition of salts on the cochlea or bone ingrowth occurs.

The most effective cases of installing a cochlear implant are those patients who have previously actively used a hearing aid, are able to speak and are relatively socially adapted.

The timing of implant installation is important - the earlier the operation is performed, the more successful its result will be.

Traditional medicine recipes

It should be noted that treatment with folk remedies should not be perceived as the only correct and effective way to get rid of hearing loss. But for prevention and during periods of persistent remission of the disease, the following recipes can be successfully used:

Propolis tincture must be mixed with vegetable oil (one part tincture to three parts oil), then a gauze turunda is moistened in the resulting composition, which is placed in the ear for 10 hours. The course should consist of 15 procedures.
Moisten the turunda in freshly squeezed juice from the fruits of viburnum or rowan, place it in the sore ear and keep it for at least 6 hours in a row (you can do this at night). The course is at least 15 procedures.
Turunda soaked in freshly squeezed beet juice should be placed in the ear for 4 hours; to improve hearing, 15–20 such procedures will be required.
Mix equal parts of walnut and almond oil. A gauze turunda soaked in the composition is placed in the external auditory canal for at least 6 hours or overnight. Hearing loss should be treated in this way for at least a month.
Place a leaf of oregano, lemon balm or mint in your ear, first crushed a little until the juice begins to stand out. After the leaf becomes dry, it must be removed and replaced with a new one. The course of therapy is at least 14 days.

Any traditional recipe should be previously discussed with a doctor regarding its admissibility, effectiveness and safety for the patient.

The success of such therapy directly depends on the degree of damage to the hearing organs and the nature of its development - it is unlikely that even the most effective folk remedies will help get rid of almost complete, bilateral deafness.

The main measures to prevent the development of sensorineural hearing loss are maintaining a healthy lifestyle (frequent walks, proper rest, quitting smoking and alcoholic beverages), avoiding risk factors that can provoke the onset of the disease, and taking care of the ear apparatus.

It must be remembered that the acquired disease in most cases is provoked by the patient himself - by listening to loud music for a long time, frequent stress and colds, or taking ototoxic medications.

Even if a person does not have hearing problems, he is recommended to undergo regular examination by an otolaryngologist - this is especially true for workers in noisy production workshops, patients with frequent relapses of the flu or the presence of chronic diseases of the ENT organs.

Sensorineural (sound-receiving, perceptual) hearing loss is understood as damage to the auditory system from the receptor to the auditory zone of the cerebral cortex. It accounts for 74% of hearing loss. Depending on the level of pathology, it is divided into receptor (peripheral), retrocochlear (radicular) and central (trunk, subcortical and cortical). The division is conditional. The most common type is receptor hearing loss. Retrocochlear hearing loss occurs when the spiral ganglion and VIII nerve are damaged.

Etiology. Sensorineural hearing loss is a polyetiological disease. Its main causes are infections; injuries; chronic cerebrovascular insufficiency; noise vibration factor; presbycusis; neuroma of the VIII nerve; radioactive exposure; developmental abnormalities of the inner ear; maternal illness during pregnancy; syphilis; intoxication with certain antibiotics and medications, salts of heavy metals (mercury, lead), phosphorus, arsenic, gasoline; endocrine diseases; alcohol abuse and tobacco smoking.

Sensorineural hearing loss can be secondary to diseases that initially cause conductive or mixed hearing loss, and over time lead to functional and organic changes in the receptor cells of the organ of Corti. This happens in chronic purulent otitis media, adhesive otitis media, otosclerosis and Meniere's disease.

20-30% of deaf and deaf-mute children have congenital deafness, and 70-80% have acquired deafness. The cause of hearing loss in the postnatal period is birth trauma with asphyxia, cerebrovascular accident, as well as rhesus conflict and hemolytic jaundice.

The infectious nature of sensorineural hearing loss and deafness accounts for about 30%. In the first place are viral infections - influenza, mumps, measles, rubella, herpes, followed by epidemic cerebrospinal meningitis, syphilis, scarlet fever and typhus.

Pathogenesis. Infectious diseases affect ganglion cells, auditory nerve fibers and hair cells. Meningococci and viruses are neurotropic, while other pathogens selectively act on blood vessels, while others are vaso- and neurotropic. Under the influence of infectious agents, the capillary blood supply in the inner ear is disrupted and the hair cells of the main curl of the cochlea are damaged. A serous-fibrinous exudate with lymphocytes, neutrophils, fiber breakdown and the formation of connective tissue may form around the auditory nerve. The nervous tissue is vulnerable and within a day the disintegration of the axial cylinder, myelin and higher-lying centers begins. The damaged nerve may partially recover. Chronic degenerative processes in the nerve trunk lead to the proliferation of connective tissue and atrophy of nerve fibers.

The basis of deafness and hearing loss in epidemic cerebrospinal meningitis is bilateral purulent labyrinthitis. The receptor, ganglion cells, trunk of the eighth nerve and nuclei in the medulla oblongata are affected. After cerebrospinal meningitis, auditory and vestibular functions are often lost.

With mumps, one- or two-sided labyrinthitis quickly develops or the vessels of the inner ear are affected, resulting in hearing loss, deafness with loss of vestibular function.

With influenza, the virus is highly vaso- and neurotropic. The infection spreads hematogenously and affects hair cells and blood vessels of the inner ear. More often there is a unilateral pathology. Bullous hemorrhagic or purulent otitis media often develops. Damage to the organ of hearing of a viral nature is possible with herpes zoster with localization of the process in the cochlea and the trunk of the VIII nerve. Impairment of auditory and vestibular functions may occur.

Thus, the pathology of the hearing organ in infectious diseases is localized mainly in the receptor of the inner ear and the auditory nerve.

In 20% of cases, the cause of sensorineural hearing loss is intoxication. Among them, the first place is occupied by ototoxic drugs: aminoglycoside antibiotics (kanamycin, neomycin, monomycin, gentamicin, biomycin, tobramycin, netilmicin, amikacin), streptomycins, tbc-statics, cytostatics (endoxan, cisplatin, etc.), analgesics (antirheumatic drugs ), antiarrhythmic drugs (quinadine, etc.), tricyclic antidepressants, diuretics (Lasix, etc.). Under the influence of ototoxic antibiotics, pathological changes occur in the receptor apparatus and blood vessels, especially in the stria vascularis. Hair cells are first affected in the main curl of the cochlea, and then throughout its entire length. Hearing loss develops across the entire frequency spectrum, but more for high-pitched sounds. The microphone potentials of the cochlea, the action potential of the eighth nerve and the endolymphatic potential, that is, the resting potential, decrease. In the endolymph, the concentration of potassium decreases and sodium increases, hypoxia of hair cells and a decrease in acetylcholine in the labyrinthine fluid are noted. The ototoxic effect of antibiotics is observed with general and local use. Their toxicity depends on penetration through the blood-labyrinthine barrier, dose, duration of use and renal excretory function. These antibiotics, especially streptomycins, affect vestibular receptors. The ototoxic effect of antibiotics is sharply manifested in children.

Sensorineural hearing loss of vascular origin is associated with impaired tone of the internal carotid and vertebral arteries, and discirculation of blood flow in the vertebrobasilar region. This pathology leads to circulatory disorders in the spiral arteries and arteries of the vascular stria due to spasm, thrombus formation, hemorrhages in the endo- and perilymphatic spaces, which is often the cause of acute deafness and hearing loss.

The traumatic origin of hearing loss includes mechanical, acoustic, vibration, baro-, accelero-, electrical, actino- and chemical trauma. Mechanical trauma can cause a fracture of the base of the skull, damage to the pyramid of the temporal bone, and the VIII nerve. Barotrauma causes rupture of the tympanic membrane, round window membrane, dislocation of the stapes, and damage to the receptor cells of the organ of Corti. With prolonged exposure to high levels of noise and vibration, degenerative changes occur in the receptor against the background of vasospasm. The neurons of the spiral ganglion and the auditory nerve are also affected. Noise and vibration primarily lead to a decrease in the perception of high and low tones, less affecting their speech zone. More severe damage is observed under the influence of high-frequency impulse noise exceeding 160 dB (at shooting ranges), which causes acute irreversible sensorineural hearing loss and deafness as a result of acoustic trauma.

Presbycusis develops due to age-related atrophy of the cochlear vessels, spiral ganglion against the background of atherosclerosis, as well as changes in the overlying parts of the auditory system. Degenerative processes in the cochlea begin at the age of 30, but progress rapidly after 50 years.

The most common causes of damage to the central parts of the auditory system are tumors, chronic cerebral circulatory failure, inflammatory processes in the brain, skull injuries, etc.

Syphilitic hearing loss may first be characterized by a disturbance in sound transmission, and then in sound perception due to pathology in the cochlea and the centers of the auditory system.

Radicular sensorineural hearing loss is accompanied by neuroma of the VIII nerve.

The progression of conductive and mixed hearing loss often leads to damage to the auditory receptor and the formation of a sensory component, and then the predominance of sensorineural hearing loss. Secondary sensorineural hearing loss in chronic purulent otitis media, adhesive otitis media can develop over time as a result of toxic effects on the inner ear of microorganisms, inflammatory products and medications, as well as age-related changes in the hearing organ. In the cochlear form of otosclerosis, the cause of the sensorineural component of hearing loss is the spread of otosclerotic lesions into the scala tympani, the proliferation of connective tissue in the membranous labyrinth with damage to hair cells. In Meniere's disease, conductive hearing loss becomes mixed and then sensorineural, which is explained by progressive degenerative-dystrophic changes in the cochlea under the influence of hydrops of the labyrinth, which depends on the dysfunction of the autonomic innervation of the vessels of the inner ear and biochemical disorders in the ear lymph.

Clinic. According to the course, there are acute, chronic forms of hearing loss, as well as reversible, stable and progressive.

Patients complain of permanent unilateral or bilateral hearing loss, which occurs acutely or gradually, with progression. Hearing loss can stabilize for a long time. It is often accompanied by subjective high-frequency ear noise (squeaking, whistling, etc.) from insignificant, periodic to constant and painful. Noise sometimes becomes the patient's main concern, irritating him. With unilateral hearing loss and deafness, communication between patients and others remains normal, but with a bilateral process it becomes difficult. A high degree of hearing loss and deafness lead people to isolation, loss of emotional coloring of speech and decreased social activity.

In patients, the cause of hearing loss, its duration, course, nature and effectiveness of previous treatment are clarified. An endoscopic examination of the ENT organs is carried out, the state of the auditory and vestibular functions, as well as the ventilation function of the auditory tube are determined.

Hearing examination is important for the diagnosis of sensorineural hearing loss, the level of damage to the sensory auditory tract, as well as its differential diagnosis with conductive and mixed hearing loss. With sensorineural hearing loss, whispered speech, as it has a higher frequency, is often perceived worse than spoken speech. The duration of perception of tuning forks at all frequencies, but mainly at high frequencies, is reduced. The lateralization of sound in Weber's experiment is noted in the better hearing ear. The tuning experiments of Rinne, Federici, Jelle, and Bing are positive. Bone conduction in Schwabach's experiment is shortened in proportion to hearing loss. After blowing out the ears, there is no improvement in hearing for whispered speech. The tympanic membrane was not changed during otoscopy, its mobility was normal, the ventilation function of the auditory tube was grade I-II.

Tonal thresholds of air and bone conduction are increased. The air-bone interval is absent or does not exceed 5-10 dB in the presence of a conductive component of hearing loss. A steep drop in the curves is characteristic, especially in the high-frequency zone. There are breaks in the tonal curves (usually bone) mainly in the high frequencies. With profound hearing loss, only islands of hearing remain at certain frequencies. In most cases, 100% speech intelligibility is not achieved with speech audiometry. The speech audiogram curve is shifted from the standard curve to the right and is not parallel to it. The speech sensitivity threshold is 50 dB or more.

Suprathreshold tests often reveal the phenomenon of accelerated loudness rise (AFLP), which confirms damage to the organ of Corti. Differential sound intensity threshold (DPS) is 0.2-0.7 dB, SISI-oano – ai100%, o?iaaiu aeneiioi?oiie a?iieinoe (OAA) – 95-100 aA, no?ai aeiaie?aneee aeaiacii neooiaiai iiey (AANI). Auditory sensitivity to ultrasound decreases or it is not perceived. Ultrasound lateralization is directed to the better hearing ear. Speech intelligibility in noise is reduced or lost. Impedance audiometry showed normal tympanograms. Acoustic reflex thresholds increase towards high frequencies or are not detected. On the audiogram, auditory evoked potentials clearly show SEPs, except for the first order wave.

Neuroma of the VIII nerve is characterized by a slow progression, unilateral sensorineural hearing loss, tinnitus, tone-speech dissociation, and deterioration of speech intelligibility against a background of noise. It is distinguished by high UDG and the absence of FUNG, the lack of lateralization of sound in Weber’s experience with the lateralization of ultrasound into the healthy ear. The reverse adaptation time increases to 15 minutes, its threshold is shifted to 30-40 dB (normally 0-15 dB). Disintegration of the acoustic reflex of the stapes is noted. Normally, within 10 s the amplitude of the reflex remains constant or decreases to 50%. A reflex half-life of 1.5 s is considered pathognomonic for neuroma of the VIII nerve. The stapes reflex (ipsilateral and contralateral) may not be evoked when the affected side is stimulated. Otoacoustic emission (OAE) is not recorded on the affected side, the intervals between the I and V peaks of ASEP are lengthened. There are vestibular disorders, paresis of the facial and intermediate nerves. To diagnose acoustic neuroma, radiography of the temporal bones according to Stenvers and their tomography (conventional, computer and magnetic resonance) are performed.

With brainstem hearing loss, speech intelligibility is impaired, the DPS is 5-6 dB (the norm is 1-2 dB), the reverse adaptation time is 5-15 minutes. (norm 5-30 s), adaptation threshold shift to 30-40 dB (norm 5-10 dB). As with neuroma of the YIII nerve, there is no FUNG, ultrasound is lateralized to the better hearing ear in the absence of lateralization of sound in Weber’s experiment, the disintegration of the acoustic reflex of the stapes is noted, the interval between the I and V peaks of CVEP is lengthened, OAE on the affected side is not recorded. Pathology of the brain stem at the level of the trapezoid body leads to loss of both contralateral stapes reflexes while the ipsilateral ones are intact. Volumetric processes in the area of crossed and one non-crossed pathway are distinguished by the absence of all reflexes except the ipsilateral one on the healthy side.

Central hearing loss is characterized by tone-speech dissociation, prolongation of the latent period of auditory reactions, deterioration of speech intelligibility against a background of noise, and spatial hearing impairment in the horizontal plane. Binaural perception does not improve speech intelligibility. Patients often have difficulty understanding radio broadcasts and telephone conversations. They suffer from DSVP. There is a drop or absence of potentials to sounds of varying tonality and intensity.

Based on audiological characteristics, it is necessary to differentiate primary sensorineural hearing loss from Meniere's disease and the cochlear form of otosclerosis.

The sensorineural component of hearing loss is noted in Meniere's disease, however, positive FUNG is combined with 100% speech intelligibility and a shift in the lower limit of perceived frequencies (LPPL) to 60-80 Hz, which is characteristic of conductive hearing loss. The SISI test is 70-100%. With asymmetry of hearing, the lateralization of sound in Weber’s experiment is directed to the better hearing ear, and ultrasound is directed to the opposite ear. The fluctuating nature of hearing loss is revealed by a positive glycerol test. Spatial hearing suffers in the horizontal and vertical planes. Vestibular symptoms confirm the diagnosis.

The cochlear form of otosclerosis is similar to sensorineural hearing loss in terms of the nature of the tonal audiogram, and other audiological tests indicate the conductive nature of the hearing impairment (normal perception of ultrasound, shift of the low-frequency frequency to 60-80 Hz, high UDG with a wide DDSP, 100% speech intelligibility at high tone bone thresholds conductivity.

Treatment. There are treatments for acute, chronic and progressive sensorineural hearing loss. First, it is aimed at eliminating the cause of the disease.

Treatment of acute sensorineural hearing loss and deafness begins as early as possible, during the period of reversible changes in the nervous tissue in order to provide emergency care. If the cause of acute hearing loss is not established, then it is regarded, most often, as hearing loss of vascular origin. Intravenous drip administration of drugs is recommended for 8-10 days - reopolyglucin 400 ml, hemodez 400 ml every other day; immediately after their administration, a drip of 0.9% sodium chloride solution 500 ml is prescribed with the addition of 60 mg of prednisolone, 5 ml of 5% ascorbic acid, 4 ml of solcoseryl, 0.05 cocarboxylase, 10 ml of panangin. Etiotropic drugs for toxic sensorineural hearing loss are antidotes: unithiol (5 ml of a 5% solution intramuscularly for 20 days) and sodium thiosulfate (5-10 ml of a 30% solution intravenously 10 times), as well as an activator of tissue respiration - calcium pantothenate (20 % solution 1-2 ml per day subcutaneously, intramuscularly or intravenously). In the treatment of acute and occupational hearing loss, hyperbaric oxygen therapy is used - 10 sessions of 45 minutes each. In a recompression chamber, inhalation of oxygen or carbagene (depending on the spastic or paralytic form of vascular pathology of the brain).

Pathogenetic treatment consists of prescribing agents that improve or restore metabolic processes and regenerate nervous tissue. Vitamins of group B1, B6, A, E, cocarboxylase, ATP are used; biogenic stimulants (aloe extract, FIBS, humisol, apilak); vasodilators (nicotinic acid, papaverine, dibazole); agents that improve vascular microcirculation (trental, cavinton, stugeron); anticholinesterase drugs (galantamine, proserine); agents that improve the conductivity of nerve tissue; antihistamines (diphenhydramine, tavegil, suprastin, diazolin, etc.), glucocorticoids (prednisolone, dexamethasone). If indicated, antihypertensive drugs and anticoagulants (heparin) are prescribed.

The meatotympanic method of administering drugs is used (Soldatov I.B., 1961). Galantamine is administered with a 1-2% solution of novocaine, 2 ml daily, up to 15 injections per course. Galantamine improves the conduction of impulses in the cholinergic synapses of the auditory system, and novocaine helps reduce tinnitus.

Medicines (antibiotics, glucocorticoids, novocaine, dibazol) are administered by behind-the-ear phonophoresis or endaural electrophoresis.

During the period of stabilization of hearing loss, patients are under the supervision of an otolaryngologist; they are given courses of preventive maintenance treatment 1-2 times a year. Cavinton, trental, and piracetam are recommended for intravenous drip administration. Then stugeron (cinnarizine), multivitamins, biostimulants and anticholinesterase drugs are prescribed orally. Symptomatic therapy is carried out. Enaural electrophoresis of 1-5% potassium iodide solution, 0.5% galantamine solution, 0.5% proserine solution, 1% nicotinic acid solution is effective.

To reduce ear noise, the method of introducing anesthetics into biologically active points of the parotid region, as well as acupuncture, electropuncture, electroacupuncture, magnetic puncture and laser puncture are used. Along with reflexology, magnetotherapy is carried out with a general solinoid and locally with the “Magniter” apparatus and endaural electrical stimulation with constant pulsed unipolar current. In case of painful ear noise and ineffectiveness of conservative treatment, resection of the tympanic plexus is performed.

For persistent, long-term hearing loss with stabilization of hearing thresholds, drug treatment is generally ineffective, since the morphological substrate of sound perception in the inner ear is already damaged.

If there is bilateral hearing loss or unilateral hearing loss and deafness in the other ear, which makes speech communication difficult, hearing aids are used. A hearing aid is usually indicated when the average loss of tonal hearing at frequencies of 500, 1000, 2000 and 4000 Hz is 40-80 dB, and spoken speech is perceived at a distance of no more than 1 m from the auricle.

Currently, the industry produces several types of hearing aids. They are based on electroacoustic amplifiers with air or bone telephones. There are devices in the form of behind-the-ear hearing aids, hearing glasses, and pocket receivers. Modern miniature devices with an air telephone are made in the form of an earmold. The devices are equipped with a volume control. Some of them have a device for connecting to a telephone. The selection of devices is carried out in special hearing aid centers by an otolaryngologist-audiologist, a hearing prosthetist and a technician. Long-term use of the device is harmless, but it does not prevent the progression of hearing loss. In cases of severe sensorineural hearing loss, hearing aids are less effective than in cases of conductive hearing loss, since patients have a narrowed dynamic range of the auditory field (DAF) and FUNG is noted.

Social deafness is considered to be a loss of tonal hearing at a level of 80 dB or more, when a person does not perceive a cry near the auricle and communication among people is impossible. If the hearing aid is ineffective, and communication is difficult or impossible, then the person is taught to contact people using facial expressions and gestures. This is usually used in children. If a child has congenital deafness or it developed before mastering speech, then he is deaf and mute. The state of hearing function in children is identified as early as possible, before the age of three, when rehabilitation of hearing and speech occurs more successfully. To diagnose deafness, not only subjective audiometry methods are used, but, above all, objective methods - impedance audiometry, auditory evoked potential audiometry and otoacoustic emission. Children with a hearing loss of 70-80 dB and lack of speech are educated in schools for the deaf and mute, with II-III degrees of hearing loss - in schools for the hard of hearing, and with I-II degrees of hearing loss - in schools for the hard of hearing. There are special kindergartens for deaf and hard of hearing children. During training, sound amplification equipment for collective use and hearing aids are used.

In recent years, electrode hearing aid has been developed and introduced - surgical implantation of electrodes into the cochlea of practically deaf people for electrical stimulation of the auditory nerve. After surgery, patients are taught verbal communication.

To prevent sensorineural hearing loss, measures are taken to reduce the harmful effects of noise and vibration, acoustic trauma and barotrauma on the hearing organ. Antiphons are used - earplugs, headphones, headsets, etc. When treating with ototoxic antibiotics, a 5% solution of unithiol is prescribed intramuscularly, and if hearing loss develops, these antibiotics are discontinued. Prevent infectious diseases and other diseases that cause hearing loss.

Military personnel with hearing loss are sent for examination to an otolaryngologist and are under the dynamic supervision of a unit doctor. If there is evidence, an examination is carried out in accordance with Article 40 of Order No. 315 of 1995 of the Ministry of Defense of the Russian Federation.