Is sensorineural hearing loss of the 1st degree an insured event? Sensorineural hearing loss: symptoms and treatment. Types of bilateral chronic sensorineural hearing loss

I am a doctor, I have been working on self-healing methods for more than 20 years. Medical statistics indicate that up to 6% of the world's population have reduced hearing or hearing loss and about 30% have a congenital pathology. At the same time, statistics show that the number of people with hearing loss increases every year.

It is considered mild in medicine, the hearing threshold is 26-40 dB and with 1 degree disability is not given. Survey and treatment hearing in ENT centers does not give any results. With hearing loss of 1st degree, people experience periodic or constant difficulties when speaking, and this is very annoying and distracts from full communication; they are constantly in tension when speaking. Doesn't allow him to do his job competently.

Hearing loss 1st degree - light form, but it’s already causing a lot of trouble. Grade 1 can often be accompanied by noise and ringing, which increases tension in communication with people. From work experience - often degree 1 hearing loss can occur with cervical osteochondrosis, we in the group do gymnastics and on the 5-6th day people often have tinnitus and their hearing is restored, therefore hearing loss can cause osteochondrosis of the cervical spine.

Sensorineural hearing loss 1st degree more often appears during stressful conditions, but can be the beginning of the development of degrees 2, 3, 4 with other damage to the hearing organs (after viral infections, consequences of drug therapy, consequences of occupational hazards, injuries, age-related changes). In our groups, grade 1 hearing loss is restored during the course and if there is tinnitus, it disappears quickly, easy and free communication with joy and without tension is restored.

Hearing loss 1 degree. Treatment without surgery or what are we doing?

What we do is self-healing techniques, i.e. the person works on his own and gradually restores his hearing. We work with the causes of hearing loss, the method of hearing restoration itself, work with the emotional state - how to keep yourself in balance, gymnastics and much more. Using our method, people restore not only their hearing, but their health - there is a complex for restoring internal organs and systems.

Example of work for the course.

Ruslan 32 years old, Kazan.

Sensorineural hearing loss 1st degree, tinnitus, ear congestion, pain in the cervical spine.

The first day of the course - I often ask questions, I get nervous, irritated, unsure of communicating with people, constrained, lack of faith in my abilities. Hearing treatment spent in various ENT centers in Kazan - no results. Hearing loss occurred in childhood. On the first day of the course - right ear whispered speech from a distance of 2 steps, left ear 1 step, congestion and tinnitus.

The ninth day of the course - a state of harmony in the soul and body, joy in life, the neck relaxed and the pain went away. Love for yourself and for the world. Congestion and tinnitus went away. The right and left ears separately hear reading a book in a whisper from a distance of 10 meters. Confident and calm communication with people. I enjoy my every day and success. The fear of communicating with people is gone, I can talk to anyone I don’t know. I can hear what people are talking about on the next park bench. I'm happy that I beat my disease!

Sensorineural hearing loss is a general hearing loss that occurs along with diseases of the inner ear, as well as the auditory nerve, or one of the central parts of the brain. According to statistics, approximately 450 million people suffer from hearing loss. About 70% of this population has sensorineural hearing loss.

Over the last years of life, there has been a steady increase in people with this pathology. It is worth noting that people of working age dominate. The growth of the disease is influenced by multiple factors, such as high incidence of influenza, increased cardiovascular pathologies, various stressful situations, noise at work, etc. The treatment of sensorineural hearing loss will depend on these factors.

Types and causes of occurrence

According to research data, scientists have come to the conclusion that almost 50% of cases of early or congenital hearing loss are directly related to heredity. The genetically predisposed sensorineural form of hearing loss refers to the hereditary form of pathologies of the hearing organs. It is estimated that one in eight people worldwide has one of the genes that can cause recessive hearing loss.

The most significant and fundamental to the development of this pathology is the connexin 26 gene. One change in this gene (the so-called 35delG mutation) leads to the formation of early hearing loss in 51% of all cases. Today, the world knows of other mutations of this gene.

Studies have shown that every 46 inhabitants of the Earth are carriers of an altered gene (mutation 35delG). From this we can draw the following conclusion that the probability of meeting people who are carriers of this gene is very high.

Forms and degrees of hearing loss

Among the total number of all cases of early or congenital hearing loss, 20-30% are due to syndromic pathology. As for non-syndromic, it accounts for 70-80%.

Non-syndromic hearing loss They call that form of pathology that, in addition to hearing loss, is not accompanied by other symptoms or diseases of other systems that are inherited along with the disease itself.

Syndromic form of hearing loss called hearing loss accompanied by other signs or diseases. For example, Pendred syndrome is accompanied by hearing impairment combined with work impairment thyroid gland.

Acquired form of hearing loss characterized by the following reasons:

• pregnancy - prematurity, low birth weight of the newborn, birth injuries, fetal hypoxia;
• chronic forms of otitis;
• various viral infections - measles, mumps, influenza, rubella, etc.;
• vascular and metabolic disorders - diabetes mellitus;
• barotrauma;
• traumatic brain injuries;
• vibration, noise.

In addition to this division, there are other forms of this pathology:

1. prelingual form (formed in the pre-speech period);
2. postlingual (formed after speech formation).

The degrees of the disease also vary:

• 1 degree of sensorineural hearing loss - 26-40 dB;
• 2nd degree sensorineural hearing loss - 41-55 dB;
• 3 degree sensorineural hearing loss - 56-70 dB;
• Grade 4 sensorineural hearing loss - 71-90 dB.

Symptoms of sensorineural hearing loss include the following:

• hearing loss;
• distortion of sounds;
• noise in ears;
• difficulty perceiving sound in a noisy environment;
• difficult communication in the company of several people, in the theater;
• it feels like they are talking to you in a low tone;
• problematic communication on the phone;
• During a conversation, you need to watch the lips of your interlocutor;
• constant repetition of words.

Diagnostics

Diagnostics includes an integrated approach, requiring examination of all auditory departments using various instrumental methods. First of all, the patient is examined by an ENT doctor in order to exclude various pathologies of the outer ear - these include cerumen plug, the presence of a foreign body, inflammation, etc.

Next, a tuning fork test and tone threshold audiometry are mandatory. To clarify what type of hearing impairment the patient has, a diagnosis of acoustic reflexes and the condition of the middle ear is carried out. Diagnosis is carried out using impedancemetry. Based on the data obtained, it is clarified what exactly is disturbed in the auditory mechanism: the state of the auditory nerve, the state of sound transmission, and sound perception are assessed.

Otoacoustic emission (a modern diagnostic method) is carried out, according to which the level of performance of auditory cells in the area of ​​the inner ear is assessed. The data is especially informative in the case of diagnosing childhood hearing.

To clarify the area of ​​damage to the auditory analyzers, auditory evoked potentials are recorded. The data allows us to assess the state of the auditory nerve, as well as the auditory stem nuclei. In most cases, hearing loss is accompanied by:

In order to select the most constructive method of treatment, it would be most correct to divide hearing loss into the following forms:

• sudden hearing loss - lasts for several minutes or hours;
• acute sensorineural hearing loss - lasts for 1 month;
• subacute sensorineural hearing loss - hearing loss can last up to 3 months;
• chronic sensorineural hearing loss - hearing loss lasts more than 3 months.

The sooner acute and sudden forms of hearing loss are treated, the greater the chance of partially or completely restoring hearing. Treatment consists of a complex course of therapy, which is carried out in conditions of complete rest (in a hospital). Treatment should be taken responsibly, since hearing loss is a rather serious disease.

Sensorineural hearing loss of an infectious nature is treated with neototoxic antibiotics. Doses are selected according to the patient's age. For a viral infection, the following drugs are prescribed:

In case of chronic bilateral sensorineural hearing loss, drug treatment fades into the background; hearing correction is first prescribed. The patient is prescribed hearing aid using modern hearing devices.

Hearing aids

People suffering from chronic sensorineural hearing loss have the only opportunity to improve their hearing through hearing aids. Today, with the help of modern high-tech devices, it is possible to achieve not only sound amplification, but also a comfortable speech sound. There are quite a few different devices that are selected individually and adjusted based on audiometry data, taking into account the patient’s sensations.

As a rule, the body of the device and the earmold itself are made according to the shape of the patient’s external auditory canal. Rehabilitation with hearing aids is not a quick process, which requires adaptation and getting used to the device. Sometimes, the period of adaptation can last for 6 months.

One of the most complex species auditory prosthetics are hearing implants. The following types of implants are distinguished:

• middle ear implant - for mild sensorineural hearing loss;
• inner ear - with severe and complete hearing loss;
• brain stem - intended to stimulate the cochlear nuclei of the brain stem;
• bone conduction implants - for patients with congenital hearing loss.

Treatment of sensorineural hearing loss, causes of its occurrence and prevention

Sensorineural (or sensorineural) hearing loss is hearing loss resulting from damage to the inner ear or auditory nerve. Unlike other types of hearing loss, in this case the sound-receiving organs are affected, not the sound-conducting organs.

What kind of disease is this: the causes of its occurrence

Sensorineural hearing loss - description and causes

The causes of this disease can be very different. Sensorineural hearing loss can be congenital. For example, there are cases of hereditary sensorineural hearing loss. Scientists have concluded that there is a special gene responsible for this disease. If the parents have it, there is a high probability that the children will also suffer from hearing loss (dominant gene), or there is still a chance to give birth healthy child(recessive gene).

We should talk specifically about hearing loss, and not about complete deafness. People suffering from this disease still recognize sounds to varying degrees.

With acquired sensorineural hearing loss, there is a high probability of being completely cured and regaining your hearing.

Congenital sensorineural hearing loss is not always inherited. It may be the result of a developmental disorder during pregnancy. As is known, the inner ear and auditory nerves are finally formed quite early on. later pregnancy. If a woman has experienced any adverse effects external factors, suffered from rubella, suffered from syphilis, chlamydia, abused alcohol, the likelihood of a child having a congenital pathology of the inner ear increases significantly.

The causes of acquired sensorineural hearing loss may be as follows:

• Infectious disease in neglected form. Hearing loss can occur as a complication if the viral disease is not treated correctly.
• Injury due to very loud and prolonged sounds. This applies to those who like to stand near speakers at discos and concerts.
• Exposure to drugs and chemicals. The effect of the drug on hearing is always indicated in the instructions in the side effects.
• Mechanical damage to the inner ear.

Treatment for sensorineural hearing loss is prescribed by an ENT doctor. Self-medication is dangerous and usually ineffective.

Symptoms and varieties

Symptoms of sensorineural hearing loss

Symptoms may not appear immediately, and the disease will only be detected during examination by an otolaryngologist. Determining the symptoms of hearing loss, for example, in a newborn child is not so easy. This is determined by a pediatrician using special tests, as well as a neurologist and ENT specialist. Premature babies are at risk. The earlier the due date, the higher the risk of hearing problems.

Symptoms of sensorineural hearing loss:

• Hearing loss. This is the main symptom that worries patients and forces them to see a doctor.
• Noise in ears. This symptom usually accompanies hearing loss. The patient feels ringing and noise in the ears.
• Other signs. In some cases, symptoms may appear that at first glance have nothing to do with hearing. If the vestibular apparatus is damaged, dizziness, nausea, vomiting, and loss of coordination occur.

The degree of hearing loss may vary. Depending on the severity of hearing loss, three degrees of the disease are distinguished:

1. Easy. With a mild degree, a person hears and recognizes spoken speech at a distance of 4-8 m from himself. The hearing loss is slight.
2. Average. The patient hears at a distance of 1-4 m. The hearing loss is significant and noticeable.
3. Heavy. The patient hears at a distance of up to 1 m. This is a significant hearing loss that complicates life and limits a person’s capabilities. Such hearing loss is close to complete deafness.

More information about hearing loss can be found in the video.

Depending on the specific location of the damage, three types of hearing loss can be distinguished:

1. Sensory. The so-called cochlea is damaged. This is a spiral-shaped organ of the inner ear, filled with fluid and responsible for the perception of information.
2. Neurosensory. As the name already makes clear, in this case it is the nerves that transmit impulses from the inner ear to the brain that are damaged.
3. Central. The auditory nerves responsible for receiving information from the outside are damaged.

There are also chronic and acute sensorineural hearing loss. The acute form occurs abruptly, unexpectedly and, as a rule, is treated faster and easier than the chronic form. Symptoms develop literally within one day.

If the patient immediately consults a doctor, treatment proceeds quickly and hearing returns.

The chronic form lasts longer, up to several years, the symptoms are not so pronounced, which makes diagnosis difficult.

Diagnosis and treatment of the disease

Only an otolaryngologist can make a diagnosis and prescribe treatment. He will definitely examine your ear and conduct audiometric tests.

To determine the exact cause of the disease, a procedure such as impedance measurement is performed. Using a small device, a sound is sent to the ear, which causes the eardrum to vibrate. A small microphone records the sound pressure that is reflected from this membrane.

Mild forms of sensorineural hearing loss are treated on an outpatient basis, but in case of serious disorders they may be admitted to the ENT department.

Treatment is carried out in several areas:

• In case of sensorineural hearing loss, it is necessary to restore and improve the blood supply to the organs of the inner ear and brain. For this purpose, the doctor prescribes drugs that improve blood flow to the organs. These include Vinpocetine, Paracetomol. These drugs are prescribed in a short course, but in large doses. To speed up the healing process, the doctor may prescribe IVs or intramuscular injections, as well as the introduction of these drugs directly into the area of ​​the inner ear using a special shunt.
• It is advisable to refrain from instilling any folk remedies into the ear unless prescribed by a doctor. They can cause harm and cause even greater hearing loss.
• There are symptoms such as dizziness, nausea, loss of stability, and medications that affect the vestibular system are prescribed. These include Betaserc, Betagestin, etc. These medications affect the cells and receptors of the inner ear, which are responsible for the position of the body in space. As a result, dizziness goes away, tinnitus decreases, and the process of hearing restoration proceeds faster. The dose is selected individually depending on the severity of the disease.
• To relieve inflammation, hormonal drugs and diuretics are prescribed. The latter have a diuretic effect and help relieve swelling in the inner ear.
• As complementary therapy Prescribe vitamins B, E, and microelements for general strengthening of the body.
• Physiotherapy is used as one of the treatment methods to improve microcirculation in the inner ear.

Complications and prevention

Possible complications and prevention of hearing loss

The acute form of sensorineural hearing loss, which was promptly and correctly treated, resolves without complications in 70-90% of cases. Hearing returns completely.

However, in the chronic form the prognosis is not so rosy. The chances that a person will hear the same as before are small, only 10-20%. The main complication that can be encountered is irreversible hearing loss.

In severe cases of the disease, the patient will have to resort to surgery or the help of a hearing aid.

You can protect yourself from acquired sensorineural hearing loss by following simple rules:

1. Avoid attending excessively noisy or loud events.
2. If there is increased level noise in the workplace, you must protect your ears with earplugs or special headphones.
3. All infectious and viral diseases It is necessary to treat on time and completely. ARVI, influenza, syphilis can lead to various complications.
4. Purulent ear diseases also need to be treated and contact an ENT specialist when the first symptoms occur. Inflammation of nearby ear organs can result in sensory deafness.
5. The expectant mother needs to closely monitor her health, do not refuse examinations, and take all necessary tests at the stage of pregnancy planning. This way you can protect your child from hearing problems.

Just because sensory hearing loss is treated doesn't mean it won't come back. Unfortunately, at the slightest sign of weakening of the body, stress, or previous infections, the disease attacks again. Therefore, you need to try not to expose your body to stress and strengthen your immune system. Take vitamins during periods of acute vitamin deficiency.

It is much easier to take care of your ears than to eliminate complications later. The simplest measures will help you avoid serious problems with hearing.

What is sensorineural hearing loss?

Sensorineural hearing loss is damage to the hearing organ caused by a dysfunction in the signal reception function of the sound-receiving apparatus located in the middle of the inner ear. The development of this pathology can be caused by several factors. The most common causes of sensorineural hearing loss are: destruction of the structure of the middle ear, atrophy of the cochlear nerve ending, damage to the cerebral cortex in the centers that are responsible for processing sound signals coming from the environment.

Sensory hearing loss is determined using a special Weber test. The tuning fork emits characteristic vibrations, and at this moment the doctor touches the bones of the patient’s skull along the midline of their location. A patient who is suspected of having this pathology of the hearing organ must report what sounds he hears directly when the tuning fork is sounded near the ear, and when the device is applied to the skull. So, the otorhinolaryngologist determines the degree of conductivity of sound signals, and how active the nerve connecting the inner ear and the brain's hearing center is.

The diagnosis of sensory hearing loss includes several degrees, namely four, each of which is characterized by a specific clinical picture of the disease.

• Sensorineural hearing loss 1st degree. The conductivity threshold for audio signals is 50 dB.
• Sensorineural hearing loss 2 degrees. The patient is able to hear spoken speech with a sound range from 50 to 60 dB.
• Sensorineural hearing loss 3 degrees. It is already considered a severe form of the disease, since a person hears sounds with a volume of at least 60 - 70 dB. To do this, the interlocutor must be in close proximity to the person suffering from hearing loss and speak as loudly as possible.
• Sensorineural hearing loss 4 degrees. It is the most complex manifestation of sensorineural hearing impairment. This is actually complete deafness. Sounds can only be heard when they sound in the range from 70 to 90 dB.

In the presence of the last degree of disease, traditional treatment medications have very little effect. The best option is the selection of a high-quality hearing aid, taking into account the specifics of the disease.

Causes of development of sensorineural hearing defect

In most cases, impaired perception of sound signals is associated with dysfunction of the cochlear nerve inside the middle ear, or with defects in hair cells, which are unique sensors that capture the slightest vibrations of sound signals. Much less commonly, sensory hearing loss is caused by damage to the cerebral cortex in the area of ​​the centers responsible for hearing. It is worth understanding in more detail all the reasons for the development of this disease.

Neurosensory damage to the hearing organ is most difficult to treat when the function is affected. auditory analyzer, so it is important to avoid noisy rooms so as not to injure this important element of the inner ear.

Congenital sensorineural hearing loss

Neurosensory hearing pathology is quite common in young children and has a congenital form of development. Sensory hearing loss in children can be caused not only by genetic abnormalities in the formation of the hearing organ, but also by the presence of many other harmful factors.

Defective development of the cochlear nerve in the inner ear.

Chromosome defects, which are responsible for the formation of elements of the hearing organ.

Congenital tumor in the middle ear, surgical removal which can lead to the destruction of the entire structure of the hearing organ itself.

Fetal alcohol dependence. Medical statistics say that if during pregnancy the mother systematically drank alcohol and suffered from alcoholism, then there is a 64% chance that the child will have congenital hearing loss. This effect on the baby’s auditory nerve is caused by toxic substances, formed during the decomposition of the components that make up alcoholic beverages.

Premature birth. Approximately 5% of newborn children have sensorineural hearing loss due to the fact that the cochlear nerve simply has not had time to fully form.

Chlamydia. If this infection is transmitted from mother to child, it can cause damage to the auditory nerve.

Syphilis. This bacterial pathogen is also transmitted from a pregnant mother to her baby in the womb, and the likelihood that the child will be born completely deaf is 30%.

Rubella. Women carrying a child under their hearts should stay as far as possible from public places where outbreaks of this virus have been recorded. For adults, rubella is actually safe, but it does affect fetal development. Negative influence. If a child, while still inside the mother, becomes infected with rubella, then in addition to neurosensory damage to the organ of hearing, eye disease occurs and a heart defect develops.

These unfavorable factors are the primary sources of congenital sensorineural hearing loss in children, which all responsible parents should be aware of.

Acquired sensorineural deafness

In addition to hereditary and congenital types of hearing loss, deafness is quite common, which was acquired by a healthy person throughout life due to the presence of certain circumstances. It is worth paying more serious attention, which can lead to hearing loss.

It is important to remember all these harmful factors that can cause hearing loss in completely healthy people.

Classification of sensorineural deafness

Based on the type of manifestation, hearing loss is divided into separate types, which are determined by an otorhinolaryngologist during an examination of the patient. When diagnosing hearing loss, it is important to correctly qualify the type of disease so that the treatment is as effective as possible and the patient’s hearing organ is restored as soon as possible.

Acute sensorineural hearing loss. It develops rapidly and is mainly provoked by bacterial and viral infections that cause inflammation inside the middle ear and in the cerebral cortex. In some cases, acute inflammation of the auditory nerve is possible, but this disease manifests itself extremely rarely.

Chronic sensorineural hearing loss. As a rule, it occurs after untreated ear diseases that have turned into sluggish inflammation. The disease may not manifest itself for a long period of time, but a person is diagnosed with otitis media consistently once or twice a year, and there is also a gradual decrease in hearing.

Bilateral sensorineural hearing loss. We are talking about damage to both sides of the inner ear, as a result of which deafness in both ears is diagnosed.

Unilateral sensorineural hearing loss. If a person cannot hear in one ear, and the reason is insufficient conductivity cochlear nerve sound signals to the cerebral cortex, then the patient is given this diagnosis.

Each of these types of disease is dangerous to human health, since if it develops further, it can progress and lead to much more serious complications.

Treatment of sensorineural hearing loss

Previously, treatment of sensorineural hearing loss with the use of traditional medications practically did not bring the desired effect. The only way to help the patient was to properly organize the selection of a high-quality device to amplify sound signals. The hearing aid was installed behind the outer part of the auricle. This practice is still used today, and signal amplification devices have become more modern, stylish, and also small in size. The patient is given the second disability group.

Treatment of sensorineural hearing loss in modern medicine has stepped forward.

Doctors have learned to carry out surgical operations, the main purpose of which is the installation of cochlear implants, which stimulate the functioning of the damaged or atrophied auditory nerve. This technique has already proven its effectiveness, but is still at the development stage. Doctors in the field of otorhinolaryngology and surgery will have to refine the technology of operations to minimize risks for patients.

Sensorineural hearing loss: degrees, treatment

In modern medical practice, a problem such as sensorineural hearing loss is quite common. This disease is associated with a gradual decrease in hearing. According to statistics, the number of patients with a similar diagnosis in Lately has increased significantly. That is why information about the main causes and signs of the disease will be useful to many readers.

What is the disease?

Sensorineural hearing loss is a disease that is associated with a general hearing loss, the cause of which may be damage to the inner ear (the organ of Corti, which converts vibrations into electrical impulses transmitted to nerve endings), the auditory nerve, or auditory centers in the brain.

Degrees of sensorineural hearing loss can vary, ranging from a slight decrease in sensitivity to sound to complete deafness. According to statistics, about 400 million people in the world today suffer from this particular pathology, and the number of registered cases of the disease is growing every year. Most often, the victims of the disease are young or mature working people. So what are the reasons for its development and what are the first symptoms?

Forms and schemes of disease classification

Today, there are many classification systems for this disease. For example, sensorineural hearing loss can be divided into congenital and acquired. In its turn, congenital pathology It happens:

• non-syndromic (the disease is accompanied only by hearing loss; in 70-80% this form is diagnosed);
• syndromic, when, along with hearing loss, the development of other diseases is observed (as an example, we can point out Pender’s syndrome, in which impaired sound perception is associated with a simultaneous functional change in the functioning of the thyroid gland).

Depending on the clinical picture and the rate of progression of the disease, it is customary to distinguish three main forms, namely:

• A sudden (rapid) form of development of the disease, in which the pathological process forms very quickly - the patient partially or completely loses hearing within 12-20 hours after the appearance of the first symptoms. By the way, timely treatment, as a rule, helps restore the functioning of a person’s hearing system.
• Acute hearing loss does not develop as quickly. As a rule, there is an increase in symptoms that lasts about 10 days. It is worth noting that many patients try to ignore the problem, attributing ear congestion and hearing loss to fatigue, wax accumulation, etc., postponing a visit to the doctor. This has a negative impact on health, while immediately started therapy increases the chances of successful treatment several times.
• Chronic sensorineural hearing loss is perhaps the most complex and dangerous form of the disease. Its course is slow and sluggish; sometimes patients live with the disease for years without even knowing it is present. Hearing can decline for years until persistent, annoying tinnitus forces you to see a doctor. This form is much more difficult to treat with medication, and quite often it is not possible to restore hearing. In some cases, this pathology leads to disability.

There are other classification systems. For example, hearing loss can be either unilateral (affects only one ear) or bilateral, and can develop both in infancy (even before the child learns to speak) and in adulthood.

Degrees of development of sensorineural hearing loss

Today, it is customary to distinguish four degrees of disease progression:

• Sensorineural hearing loss of the 1st degree is accompanied by a decrease in the sensitivity threshold to 26-40 dB. A person can distinguish sounds at a distance of 6 meters, and a whisper - from no more than three meters.
• Sensorineural hearing loss of the 2nd degree - in such cases, the patient’s hearing threshold is 41-55 dB, he can hear at a distance of no more than 4 meters. Difficulties perceiving sound can occur even in a calm, quiet environment.
• The third degree of the disease is characterized by a sound threshold of 56-70 dB - a person can distinguish normal speech at a distance of no more than a meter, and not in a noisy place.
• The threshold for sound perception at the fourth stage is 71-90 dB - these are serious disorders, sometimes up to complete deafness.

The main causes of the disease

In fact, there are many factors that can cause sensorineural hearing loss. The most common include:

• frequent infectious diseases, in particular otitis media, influenza and other colds, which can cause complications;
• vascular thrombosis;
• inflammatory diseases, for example, adenoiditis, labyrinthitis, meningitis;
• otosclerosis;
• progressive atherosclerosis;
• acoustic trauma;
• traumatic brain injuries;
• autoimmune diseases;
• tumor between the cerebellum and the pons;
• application of some medicines, in particular salicylates, aminoglycosides;
• damage to the auditory nerve or inner ear from chemicals or toxins;
• working in a noisy industry;
• constantly listening to loud music;
• according to statistical research, residents of large cities often suffer from a similar disease.

Sensorineural hearing loss in children: congenital causes

The causes of acquired hearing loss were described above. However, some children suffer from this disease almost from birth. So what are the reasons for the development of the disease? There are quite a lot of them:

• genetic inheritance (it is believed that almost 50% of the planet’s inhabitants are carriers of genes for one or another form of hearing loss);
• congenital aplasia of the cochlea or other anatomical abnormalities;
• intrauterine infection of the fetus with the rubella virus;
• presence of alcohol syndrome in a pregnant woman;
• reception narcotic drugs mother;
• such a disorder may be a complication of syphilis;
• Risk factors include early birth;
• Sometimes hearing loss develops as a result of a child becoming infected with chlamydia during childbirth.

What symptoms accompany the disease?

As already noted, the clinical picture may vary depending on the rate of progression of hearing loss. As a rule, tinnitus appears first, and sounds may also be distorted. For example, some patients complain that all sounds are perceived as if in lower tones.

Hearing loss develops gradually. People have difficulty hearing sound in a noisy environment or in a crowded group. As the disease progresses, problems with telephone communication arise. When talking to a person, the patient, as a rule, begins to unconsciously follow the movement of the lips, as this helps to distinguish sounds. Patients constantly repeat words. As the disease progresses, the problems become more pronounced - if the patient is not helped, the consequences can be dire.

Basic diagnostic methods

Hearing loss is an extremely serious problem, so if you have any symptoms, you should immediately consult a doctor. Diagnosis in this case is a complex process that begins with an examination by an ENT doctor. If during the examination it was possible to reveal that hearing loss is in no way connected with the structure and functions of the outer ear, then other studies are carried out, in particular, tone threshold audiometry, tuning fork tests, impedance measurements, otoacoustic emissions and some others. As a rule, during the diagnostic process, specialists are able to find out not only the presence of a developing pathology, but also the causes of its occurrence.

Sensorineural hearing loss: treatment

It should be said right away that self-medication in this case is unacceptable. The treatment regimen is selected by the attending physician after a thorough diagnosis. So what to do with a diagnosis of sensorineural hearing loss?

Treatment of the acute form of the disease can be medicinal and depends on the causes of its development. For example, if an infection is present, anti-inflammatory, antiviral or antibacterial drugs. Additionally, vitamins of group B and E may be prescribed. In the presence of severe edema, diuretics and hormonal medications are used.

When is prosthetics necessary?

Alas, sensorineural hearing loss cannot always be cured using conservative medicine methods. And if the acute form of the disease responds well to drug treatment, then in case of chronic hearing loss such methods are unlikely to have an effect.

In some cases, the only way to restore a person's hearing is to use a hearing aid. By the way, modern models are small in size and high sensitivity, which makes them convenient to use.

Thanks to the achievements of modern otosurgery, in some forms of the disease, so-called cochlear implantation is possible, which involves placing special electrodes in the inner ear that can stimulate the auditory nerve. This technique is used only if hearing loss is associated specifically with disruption of the organ of Corti, but the auditory nerve and brain centers are working normally.

Sensorineural hearing loss - what is it and how to treat it

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.

At acute course diseases, 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 it is usually prescribed ambulatory treatment 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.

Sensorineural hearing loss

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, with untimely treatment which causes destruction of 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 effect 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 (labyrinthitis in purulent form), 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 rhinitis allergic form, causing frequent otitis. To the number autoimmune pathologies causing 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

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 the hearing loss is observed only with 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.

Chronic hearing loss can occur in a progressive or stable stage

Degrees of hearing loss

Pathology has four degrees:

• Sensorineural hearing loss of 1st degree is considered the mildest 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 of the 2nd degree is 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 of the 3rd degree is 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 – hearing function is almost completely lost, leading to the patient being unable to 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 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 suffered from any infectious pathologies in the recent period, whether he has taken toxic drugs, have 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 quick selection suitable treatment tactics. Used during therapy the following groups drugs:

• 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 drugs, metabolic stimulants and vitamin complexes. Physiotherapeutic procedures are also indicated for the patient.

If drug treatment sensorineural hearing loss gives positive results, and dynamic improvements are confirmed by hardware studies, the doctor prescribes 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.

Cochlear implantation

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 cannot be perceived as the only correct and effective method 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.

(bradycusis or hypoacusis) is a hearing impairment of varying severity (from slight to profound), occurring suddenly or developing gradually, and caused by a disorder in the functioning of the sound-receiving or sound-conducting structures of the auditory analyzer (ear). With hearing loss, a person has difficulty hearing various sounds, including speech, as a result of which normal communication and any communications with other people are difficult, which leads to his desocialization.

Deafness is a kind of final stage of hearing loss and represents an almost complete loss of the ability to hear various sounds. With deafness, a person cannot hear even very loud sounds, which normally cause pain in the ears.

Deafness and hearing loss can affect only one or both ears. Moreover, hearing loss in different ears can have different degrees of severity. That is, a person can hear better with one ear and worse with the other.

Deafness and hearing loss - a brief description

Hearing loss and deafness are types of hearing disorders in which a person loses the ability to hear various sounds. Depending on the severity of hearing loss, a person can hear a greater or lesser range of sounds, and with deafness there is a complete inability to hear any sounds. In general, deafness can be considered as the last stage of hearing loss, in which complete loss of hearing occurs. The term “hearing loss” usually means hearing impairment of varying degrees, in which a person can hear at least very loud speech. Deafness is a condition in which a person is no longer able to hear even very loud speech.

Hearing loss or deafness can affect one or both ears, and the severity may be different in the right and left ear. Since the development mechanisms, causes, as well as treatment methods for hearing loss and deafness are the same, they are combined into one nosology, considering them as successive stages of one pathological process of human hearing loss.

Hearing loss or deafness can be caused by damage to sound-conducting structures (organs of the middle and outer ear) or sound-receiving apparatus (organs of the inner ear and brain structures). In some cases, hearing loss or deafness may be caused by simultaneous damage to both sound-conducting structures and the sound-receiving apparatus of the auditory analyzer. In order to clearly understand what damage to a particular hearing analyzer means, you need to know its structure and functions.

So, the auditory analyzer consists of the ear, the auditory nerve and the auditory cortex of the brain. With the help of the ears, a person perceives sounds, which are then transmitted in encoded form along the auditory nerve to the brain, where the received signal is processed and the sound is “recognized.” Due to its complex structure, the ear not only picks up sounds, but also “recodes” them into nerve impulses that are transmitted to the brain along the auditory nerve. The perception of sounds and their “recoding” into nerve impulses are produced by various structures of the ear.

Thus, the structures of the outer and middle ear, such as the eardrum and the auditory ossicles (hammer, incus and stapes), are responsible for the perception of sounds. It is these parts of the ear that receive sound and conduct it to the structures of the inner ear (cochlea, vestibule and semicircular canals). And in the inner ear, the structures of which are located in the temporal bone of the skull, “recoding” occurs sound waves into electrical nerve impulses, which are subsequently transmitted to the brain along the corresponding nerve fibers. The processing and “recognition” of sounds occurs in the brain.

Accordingly, the structures of the outer and middle ear are sound-conducting, and the organs of the inner ear, auditory nerve and cerebral cortex are sound-receiving. Therefore, the entire set of hearing loss options is divided into two large groups - those associated with damage to the sound-conducting structures of the ear or the sound-receiving apparatus of the hearing analyzer.

Hearing loss or deafness can be acquired or congenital, and depending on the time of occurrence - early or late. Early hearing loss is considered to be acquired before the child reaches the age of 3–5 years. If hearing loss or deafness appeared after the age of 5, then it is classified as late.

Acquired hearing loss or deafness is usually associated with the negative impact of various external factors, such as ear injuries, previous infections complicated by damage to the auditory analyzer, constant noise exposure, etc. Separately, acquired hearing loss caused by age-related changes in the structure of the auditory analyzer, which are not associated with any negative effects on the hearing organ. Congenital hearing loss is usually caused by developmental defects, genetic abnormalities of the fetus, or certain infectious diseases suffered by the mother during pregnancy (rubella, syphilis, etc.).

The specific causative factor of hearing loss is determined during a special otoscopic examination performed by an ENT doctor, audiologist or neurologist. In order to select the optimal method of treating hearing loss, it is necessary to find out what is causing the hearing loss - damage to the sound-conducting or sound-receiving apparatus.

Treatment of hearing loss and deafness is carried out using various methods, including both conservative and surgical. Conservative methods are usually used to restore sharply deteriorated hearing due to a known causative factor (for example, hearing loss after taking antibiotics, after a traumatic brain injury, etc.). In such cases, with timely treatment, hearing can be restored by 90%. If conservative therapy was not carried out as soon as possible after hearing deterioration, then its effectiveness is extremely low. In such situations, conservative treatment methods are considered and used exclusively as auxiliary ones.

Surgical treatment methods are variable and can restore a person’s hearing in the vast majority of cases. Most of operational methods Treatment of hearing loss is associated with the selection, installation and adjustment of hearing aids, which allow a person to perceive sounds, hear speech and interact normally with others. Another large group of methods for surgical treatment of hearing loss involves very complex operations on the installation of cochlear implants, which make it possible to restore the ability to perceive sounds to people who cannot use hearing aids.

The problem of hearing loss and deafness is very important, since a hard of hearing person finds himself isolated from society, his employment opportunities and self-realization are sharply limited, which, of course, leaves a negative imprint on the entire life of a hearing-impaired person. The consequences of hearing loss are most severe in children, since their poor hearing can lead to muteness. After all, the child has not yet mastered speech very well; he needs constant practice and further development speech apparatus, which are achieved only with the help of constant auditory perception of new phrases, words, etc. And when a child does not hear speech, he can completely lose even the existing ability to speak, becoming not just hard of hearing, but also mute.

It must be remembered that about 50% of cases of hearing loss can be prevented with proper adherence to preventive measures. Thus, effective preventive measures are vaccination of children, adolescents and women of childbearing age against dangerous infections, such as measles, rubella, meningitis, mumps, whooping cough, etc., which can cause complications in the form of otitis media and other ear diseases. Also effective preventive measures to prevent hearing loss are high-quality obstetric care for pregnant women and women in labor, proper hygiene of the ears, timely and adequate treatment of diseases of the ENT organs, avoiding the use of drugs toxic to the auditory analyzer, as well as minimizing noise exposure to the ears in industrial and other premises (for example , when working in noisy areas, you should wear earplugs, noise-canceling headphones, etc.).

Deafness and muteness

Deafness and muteness are quite often combined, the latter being a consequence of the former. The fact is that a person masters and then constantly maintains the ability to speak, to pronounce articulate sounds only on the condition that he constantly hears them both from other people and from himself. When a person stops hearing sounds and speech, it becomes difficult for him to speak, as a result of which speech skills are reduced (deteriorated). A pronounced reduction in speech skills ultimately leads to muteness.

Children who become hard of hearing before the age of 5 years are especially susceptible to the secondary development of muteness. Such children gradually lose the speech skills they have already acquired, and they become mute due to the fact that they cannot hear speech. Children who are deaf from birth are almost always mute, since they cannot master speech without simply hearing it. After all, a child learns to speak by listening to other people and trying to pronounce imitating sounds on his own. But a deaf baby does not hear sounds, as a result of which he simply cannot even try to pronounce something, imitating those around him. It is because of the inability to hear that children who are deaf from birth remain mute.

Adults who have acquired hearing loss become mute in very rare cases, since their speech skills are well developed and are lost very slowly. An adult who is deaf or hard of hearing may speak strangely, drawing out words or pronouncing them very loudly, but the ability to reproduce speech is almost never completely lost.

Deafness in one ear

Deafness in one ear is usually acquired and is quite common. Such situations usually occur when negative factors affect only one ear, as a result of which it ceases to perceive sounds, while the second remains completely normal and fully functioning. Deafness in one ear does not necessarily provoke hearing impairment in the second ear; moreover, a person can live the rest of his life with a single functioning ear, maintaining normal hearing. However, if you have deafness in one ear, you need to take care of the second organ, since if it is damaged, the person will stop hearing altogether.

Deafness in one ear in terms of development mechanisms, causes and methods of treatment is no different from any type of acquired hearing loss.

With congenital deafness, the pathological process usually affects both ears, since it is associated with systemic disturbances in the functioning of the entire auditory analyzer.

Classification

Let us consider the various forms and types of hearing loss and deafness, which are distinguished depending on one or another leading feature that forms the basis of the classification. Since there are several leading signs and characteristics of hearing loss and deafness, there is more than one type of disease identified on their basis.

Depending on which structure of the auditory analyzer is affected - sound-conducting or sound-perceiving, the entire various options Hearing loss and deafness are divided into three large groups:
1. Sensorineural (sensorineural) hearing loss or deafness.
2. Conductive hearing loss or deafness.
3. Mixed hearing loss or deafness.

Sensorineural (sensorineural) hearing loss and deafness

Sensorineural hearing loss or deafness is caused by damage to the sound-receiving apparatus of the auditory analyzer. With sensorineural hearing loss, a person perceives sounds, but the brain does not perceive or recognize them, as a result of which, in practice, there is hearing loss.

Sensorineural hearing loss is not one disease, but a whole group various pathologies, which lead to disruption of the functioning of the auditory nerve, inner ear or auditory cortex. But since all these pathologies affect the sound-perceiving apparatus of the auditory analyzer, and therefore have a similar pathogenesis, they are combined into one large group of sensorineural hearing loss. Morphologically, sensorineural deafness and hearing loss can be caused by a disorder in the functioning of the auditory nerve and cerebral cortex, as well as anomalies in the structure of the inner ear (for example, atrophy of the sensory apparatus of the cochlea, changes in the structure of the vascular cavity, spiral ganglion, etc.) arising due to genetic violations or due to past illnesses and injuries.

That is, if hearing loss is associated with dysfunction of the structures of the inner ear (cochlea, vestibule or semicircular canals), the auditory nerve (VIII pair of cranial nerves) or areas of the cerebral cortex responsible for the perception and recognition of sounds, these are precisely neurosensory options for reduction hearing

By origin, sensorineural hearing loss and deafness can be congenital or acquired. Moreover, congenital cases of sensorineural hearing loss account for 20%, and acquired cases, respectively, for 80%.

Cases of congenital hearing loss can be caused either by genetic disorders in the fetus or by abnormalities in the development of the auditory analyzer that arise due to the adverse effects of environmental factors during fetal development. Genetic disorders are present in the fetus initially, that is, they are transmitted from the parents at the time of fertilization of the egg by the sperm. If the sperm or egg has any genetic abnormalities, then the fetus will have intrauterine development a full-fledged auditory analyzer will not be formed, which will lead to congenital sensorineural hearing loss. But abnormalities in the development of the auditory analyzer in the fetus, which can also cause congenital hearing loss, occur during the period of bearing a child with initially normal genes. That is, the fetus received normal genes from its parents, but during the period of intrauterine growth it was affected by any unfavorable factors (for example, infectious diseases or poisoning suffered by a woman, etc.), which disrupted the course of its normal development, which resulted in abnormal formation of the auditory analyzer, manifested by congenital hearing loss.

Congenital hearing loss in most cases is one of the symptoms of a genetic disease (for example, Treacher-Collins, Alport, Klippel-Feil, Pendred syndromes, etc.) caused by mutations in genes. Congenital hearing loss, as the only disorder that is not combined with any other functional disorders different organs and systems and caused by developmental anomalies, is relatively rare, no more than 20% of cases.

The causes of congenital sensorineural hearing loss, which develops as a developmental anomaly, can be severe infectious diseases (rubella, typhus, meningitis, etc.) suffered by a woman during pregnancy (especially during 3–4 months of gestation), intrauterine infection of the fetus with various infections (for example, toxoplasmosis, herpes, HIV, etc.), as well as maternal poisoning with toxic substances (alcohol, drugs, industrial emissions, etc.). The causes of congenital hearing loss caused by genetic disorders are the presence of genetic abnormalities in one or both parents, consanguineous marriage, etc.

Acquired hearing loss always occurs against the background of initially normal hearing, which decreases due to the negative impact of some environmental factors. Sensorineural hearing loss of acquired origin can be provoked by brain damage (traumatic brain injury, hemorrhage, birth trauma in a child, etc.), diseases of the inner ear (Meniere's disease, labyrinthitis, complications of mumps, otitis media, measles, syphilis, herpes, etc.). etc.), acoustic neuroma, prolonged exposure to noise in the ears, as well as taking medications that are toxic to the structures of the auditory analyzer (for example, Levomycetin, Gentamicin, Kanamycin, Furosemide, etc.).

Separately, we should highlight a variant of sensorineural hearing loss, which is called presbycusis, and consists of a gradual decrease in hearing as one grows up or ages. With presbycusis, hearing is lost slowly, and at first the child or adult ceases to hear high frequencies (birds singing, squeaking, telephone ringing, etc.), but perceives low tones well (the sound of a hammer, a passing truck, etc.). Gradually, the spectrum of perceived frequencies of sounds narrows due to the increasing deterioration of hearing for higher tones, and, ultimately, the person ceases to hear at all.

Conductive hearing loss and deafness

The group of conductive hearing loss and deafness includes various conditions and diseases that lead to disruption of the functioning of the sound-conducting system of the auditory analyzer. That is, if hearing loss is associated with any disease affecting the sound-conducting system of the ear (eardrums, external auditory canal, auricle, auditory ossicles), then it belongs to the conductive group.

It is necessary to understand that conductive hearing loss and deafness are not one pathology, but a whole group of the most various diseases and conditions united by the fact that they affect the sound-conducting system of the auditory analyzer.

With conductive hearing loss and deafness, sounds from the outside world do not reach the inner ear, where they are “recoded” into nerve impulses and from where they enter the brain. Thus, a person does not hear because the sound does not reach the organ that can transmit it to the brain.

As a rule, all cases of conductive hearing loss are acquired and caused by various diseases and injuries that disrupt the structure of the outer and middle ear (for example, wax plugs, tumors, otitis media, otosclerosis, damage to the eardrum, etc.). Congenital conductive hearing loss is rare and is usually one of the manifestations of some genetic disease caused by gene abnormalities. Congenital conductive hearing loss is always associated with abnormalities in the structure of the outer and middle ear.

Mixed hearing loss and deafness

Mixed hearing loss and deafness are hearing loss due to a combination of conductive and sensorineural disorders.

Depending on the period of a person’s life when hearing impairment began, congenital, hereditary and acquired hearing loss or deafness are distinguished.

Hereditary hearing loss and deafness

Hereditary hearing loss and deafness are variants of hearing impairment that arise as a result of existing genetic abnormalities in a person, which were passed on to him from his parents. In other words, with hereditary hearing loss and deafness, a person receives genes from their parents that sooner or later lead to hearing impairment.

Hereditary hearing loss can appear at different ages, i.e. it is not necessarily congenital. Thus, with hereditary hearing loss, only 20% of children are born deaf, 40% begin to lose hearing in childhood, and the remaining 40% notice a sudden and causeless hearing loss only in adulthood.

Hereditary hearing loss is caused by certain genes, which are usually recessive. This means that a child will only have hearing loss if he receives recessive deafness genes from both parents. If a child receives a dominant gene for normal hearing from one of the parents, and a recessive gene for deafness from the other, then he will hear normally.

Since the genes for hereditary deafness are recessive, this type of hearing impairment usually occurs in closely related marriages, as well as in unions of people whose relatives or they themselves suffered from hereditary hearing loss.

The morphological substrate of hereditary deafness can be various disorders of the structure of the inner ear, which arise due to defective genes passed on to the child by the parents.

Hereditary deafness, as a rule, is not the only health disorder that a person has, but in the vast majority of cases it is combined with other pathologies, also of a genetic nature. That is, usually hereditary deafness is combined with other pathologies that also developed as a result of abnormalities in the genes passed on to the child by the parents. Most often, hereditary deafness is one of the symptoms genetic diseases, which are manifested by a whole complex of symptoms.

Currently, hereditary deafness, as one of the symptoms of a genetic anomaly, occurs in the following diseases associated with abnormalities in genes:

• Treacher Collins syndrome(deformation of the skull bones);
• Alport syndrome(glomerulonephritis, hearing loss, reduced functional activity of the vestibular apparatus);
• Pendred syndrome(dysfunction of thyroid hormone metabolism, large head, short arms and legs, enlarged tongue, disorder of the vestibular apparatus, deafness and muteness);
• LEOPARD syndrome (cardiopulmonary failure, abnormalities in the structure of the genital organs, freckles and age spots throughout the body, deafness or hearing loss);
• Klippel-Feil syndrome(impaired structure of the spine, arms and legs, incompletely formed external auditory canal, hearing loss).

Deafness genes

Currently, more than 100 genes have been discovered that can lead to hereditary hearing loss. These genes are located on different chromosomes, and some are associated with genetic syndromes and others are not. That is, some deafness genes are an integral part of various genetic diseases, which are manifested by a whole complex of disorders, and not just hearing impairment. And other genes cause only isolated deafness, without any other genetic abnormalities.

The most common deafness genes are:

• OTOF(the gene is located on chromosome 2 and if it is present, a person suffers from hearing loss);
• GJB2(a mutation in this gene, called 35 del G, causes hearing loss in humans).

Mutations in these genes can be identified during genetic testing.

Congenital hearing loss and deafness

These types of hearing loss occur during the intrauterine development of a child under the influence of various unfavorable factors. In other words, a child is born with hearing loss, which arose not due to genetic mutations and anomalies, but due to the influence of unfavorable factors that disrupted the normal formation of the auditory analyzer. It is in the absence of genetic disorders that the fundamental difference between congenital and hereditary hearing loss lies.

Congenital hearing loss can occur when a pregnant woman’s body is exposed to the following unfavorable factors:

• Damage to the central nervous system child due to birth trauma (for example, hypoxia due to entanglement of the umbilical cord, compression of the skull bones due to the application of obstetric forceps, etc.) or anesthesia. In these situations, hemorrhages occur in the structures of the auditory analyzer, as a result of which the latter is damaged and the child develops hearing loss.
• Infectious diseases suffered by a woman during pregnancy , especially at 3–4 months of gestation, which can disrupt the normal formation of the fetal hearing system (for example, influenza, measles, chickenpox, mumps, meningitis, cytomegalovirus infection, rubella, syphilis, herpes, encephalitis, typhoid fever, otitis media, toxoplasmosis, scarlet fever, HIV). The causative agents of these infections are able to penetrate to the fetus through the placenta and disrupt the normal course of formation of the ear and auditory nerve, which will result in hearing loss in the newborn child.
• Hemolytic disease of the newborn. With this pathology, hearing loss occurs due to impaired blood supply to the central nervous system of the fetus.
• Severe somatic diseases of a pregnant woman, accompanied by vascular damage (for example, diabetes mellitus, nephritis, thyrotoxicosis, cardiovascular diseases). In these diseases, hearing loss occurs due to insufficient blood supply to the fetus during pregnancy.
• Smoking and drinking alcohol during pregnancy.
• Constant exposure of a pregnant woman’s body to various industrial poisons and toxic substances (for example, when living in a region with an unfavorable environmental situation or working in hazardous industries).
• Use of medications during pregnancy that are toxic to the auditory analyzer (for example, Streptomycin, Gentamicin, Monomycin, Neomycin, Kanamycin, Levomycetin, Furosemide, Tobramycin, Cisplastin, Endoxan, Quinine, Lasix, Uregit, Aspirin, ethacrynic acid, etc.).

Acquired hearing loss and deafness

Acquired hearing loss and deafness occur in people of different ages during life under the influence of various unfavorable factors that disrupt the functioning of the auditory analyzer. This means that acquired hearing loss can occur at any time due to a possible causative factor.

Thus, possible causes of acquired hearing loss or deafness are any factors that lead to disruption of the structure of the ear, auditory nerve or cerebral cortex. These factors include severe or chronic diseases ENT organs, complications of infections (for example, meningitis, typhus, herpes, mumps, toxoplasmosis, etc.), head injuries, contusion (for example, a kiss or loud scream directly into the ear), tumors and inflammation of the auditory nerve, prolonged exposure to noise , circulatory disorders in the vertebrobasilar region (for example, strokes, hematomas, etc.), as well as taking medications that are toxic to the auditory analyzer.

Based on the nature and duration of the pathological process, hearing loss is divided into acute, subacute and chronic.

Acute hearing loss

Acute hearing loss is a significant deterioration in hearing over a short period of time lasting no more than 1 month. In other words, if hearing loss occurred within a maximum of a month, then we are talking about acute hearing loss.

Acute hearing loss does not develop all at once, but gradually, and at the initial stage a person feels fullness in the ear or tinnitus, rather than hearing impairment. A feeling of fullness or tinnitus may periodically appear and disappear, being preliminary signs of impending hearing loss. And only some time after the sensation of congestion or noise in the ears appears, a person experiences a persistent deterioration in hearing.

The causes of acute hearing loss are various factors that damage the structures of the ear and the area of ​​the cerebral cortex responsible for recognizing sounds. Acute hearing loss can occur after a head injury, after infectious diseases (for example, otitis media, measles, rubella, mumps, etc.), after hemorrhages or circulatory disorders in the structures of the inner ear or brain, as well as after taking toxic substances for the ear. medications (for example, Furosemide, Quinine, Gentamicin), etc.

Acute hearing loss is amenable to conservative therapy, and the success of treatment depends on how quickly it is started relative to the appearance of the first signs of the disease. That is, the earlier treatment for hearing loss is started, the greater the likelihood of hearing normalization. It must be remembered that successful treatment of acute hearing loss is most likely when therapy is initiated within the first month after hearing loss. If more than a month has passed since hearing loss, then conservative therapy, as a rule, turns out to be ineffective and only allows one to maintain hearing at the current level, preventing it from deteriorating even more.

Among cases of acute hearing loss, a separate group also includes sudden deafness, in which a person experiences a sharp deterioration in hearing within 12 hours. Sudden deafness appears suddenly, without any preliminary signs, against the background of complete well-being, when a person simply stops hearing sounds.

As a rule, sudden deafness is one-sided, that is, the ability to hear sounds is reduced in only one ear, while the other remains normal. In addition, sudden deafness is characterized by severe hearing impairment. This form of hearing loss is caused by viral infections, and therefore has a more favorable prognosis compared to other types of deafness. Sudden hearing loss responds well to conservative treatment, thanks to which hearing can be completely restored in more than 95% of cases.

Subacute hearing loss

Subacute hearing loss, in fact, is a variant of acute deafness, since they have the same causes, development mechanisms, course and principles of therapy. Therefore, identifying subacute hearing loss as a separate form of the disease does not have high practical significance. As a result, doctors often divide hearing loss into acute and chronic, and subacute variants are classified as acute. Subacute, from the standpoint of academic knowledge, is considered hearing loss, the development of which occurs within 1 to 3 months.

Chronic hearing loss

In this form, hearing loss occurs gradually over a long period of time, lasting more than 3 months. That is, over several months or years, a person faces a steady but slow deterioration in hearing. When hearing stops deteriorating and begins to remain at the same level for six months, hearing loss is considered fully developed.

With chronic hearing loss, hearing loss is combined with constant noise or ringing in the ears, which is not audible to others, but is very difficult for the person to tolerate.

Deafness and hearing loss in a child

Children of all ages can suffer from all types and forms of hearing loss or deafness. The most common cases of congenital and genetic hearing loss in children occur; acquired deafness develops less frequently. Among cases of acquired deafness, most are caused by taking medications that are toxic to the ear and complications of infectious diseases.

The course, mechanisms of development and treatment of deafness and hearing loss in children are the same as in adults. However, the treatment of hearing loss in children is given higher value than in adults, since for this age category hearing is critical for mastering and maintaining speech skills, without which the child will become not only deaf, but also dumb. Otherwise, there are no fundamental differences in the course, causes and treatment of hearing loss in children and adults.

Causes

To avoid confusion, we will consider separately the causes of congenital and acquired hearing loss and deafness.

The causative factors of congenital hearing loss are various negative effects on a pregnant woman, which lead, in turn, to disruption of the normal growth and development of the gestating fetus. Therefore, the causes of congenital hearing loss are factors that influence not so much the fetus itself as the pregnant woman. So, Possible causes of congenital and genetic hearing loss are the following factors:

• Damage to the child’s central nervous system due to birth trauma (for example, hypoxia due to entanglement of the umbilical cord, compression of the skull bones when applying obstetric forceps, etc.);
• Damage to the child's central nervous system due to anesthetic drugs administered to the woman during childbirth;
• Infectious diseases suffered by a woman during pregnancy, which can disrupt the normal formation of the fetal hearing system (for example, influenza, measles, chickenpox, mumps, meningitis, cytomegalovirus infection, rubella, syphilis, herpes, encephalitis, typhoid fever, otitis media, toxoplasmosis, scarlet fever, HIV);
• Hemolytic disease of newborns;
• Pregnancy occurring against the background of severe somatic diseases in a woman, accompanied by vascular damage (for example, diabetes mellitus, nephritis, thyrotoxicosis, cardiovascular diseases);
• Smoking, drinking alcohol or using drugs during pregnancy;
• Constant exposure of a pregnant woman’s body to various industrial poisons (for example, constant presence in a region with an unfavorable environmental situation or work in hazardous industries);
• Use during pregnancy of medications that are toxic to the auditory analyzer (for example, Streptomycin, Gentamicin, Monomycin, Neomycin, Kanamycin, Levomycetin, Furosemide, Tobramycin, Cisplastin, Endoxan, Quinine, Lasix, Uregit, Aspirin, ethacrynic acid, etc.);
• Pathological heredity (transmission of deafness genes to a child);
• Consanguineous marriages;
• Birth of a baby prematurely or with low birth weight.

Possible causes of acquired hearing loss in people of any age may include the following factors:

• Birth trauma (a child may receive a central nervous system injury during childbirth, which subsequently leads to hearing loss or deafness);
• Hemorrhages or hematomas in the middle or inner ear or in the cerebral cortex;
• Poor circulation in the vertebrobasilar system (a set of vessels supplying all structures of the skull);
• Any damage to the central nervous system (for example, traumatic brain injury, brain tumors, etc.);
• Surgeries on the hearing organs or brain;
• Complications on the ear structures after suffering inflammatory diseases, such as, for example, labyrinthitis, otitis, measles, scarlet fever, syphilis, mumps, herpes, Meniere's disease, etc.;
• Acoustic neuroma;
• Long-term exposure to noise on the ears (for example, frequent listening to loud music, working in noisy workshops, etc.);
• Chronic inflammatory diseases of the ears, nose and throat (for example, sinusitis, otitis, eustachitis, etc.);
• Chronic ear pathologies (Meniere's disease, otosclerosis, etc.);
• Hypothyroidism (deficiency of thyroid hormones in the blood);
• Taking medications that are toxic to the auditory analyzer (for example, Streptomycin, Gentamicin, Monomycin, Neomycin, Kanamycin, Levomycetin, Furosemide, Tobramycin, Cisplastin, Endoxan, Quinine, Lasix, Uregit, Aspirin, ethacrynic acid, etc.);
• Sulfur plugs;
• Damage to the eardrums;
• Age-related hearing impairment (presbycusis) associated with atrophic processes in the body.

Signs (symptoms) of deafness and hearing loss

The main symptom of hearing loss is a deterioration in the ability to hear, perceive and distinguish a variety of sounds. A person suffering from hearing loss cannot hear some of the sounds that a person normally perceives well. The lower the severity of hearing loss, the greater the range of sounds a person continues to hear. Accordingly, the more severe the hearing loss, the more sounds a person, on the contrary, cannot hear.

It is necessary to know that with hearing loss of varying degrees of severity, a person loses the ability to perceive certain spectrums of sounds. Thus, with mild hearing loss, the ability to hear high and quiet sounds, such as whispering, squeaking, telephone ringing, and birdsong, is lost. As hearing loss worsens, the ability to hear sound spectrums that follow the highest tones in pitch disappears, that is, soft speech, the rustle of wind, etc. As hearing loss progresses, the ability to hear sounds belonging to the upper spectrum of perceived tones disappears, and the discrimination of low sound vibrations, such as like the rumble of a truck, etc.

A person, especially in childhood, does not always understand that he has hearing loss, since the perception of a wide range of sounds remains. That is why To identify hearing loss, it is necessary to take into account the following indirect signs of this pathology:

• Frequent questioning;
• Absolute lack of reaction to sounds of high tones (for example, bird trills, squeaking of a bell or telephone, etc.);
• Monotonous speech, incorrect placement of stress;
• Speech too loud;
• Shuffling gait;
• Difficulties in maintaining balance (noted with sensorineural hearing loss due to partial damage to the vestibular apparatus);
• Lack of reaction to sounds, voices, music, etc. (normally a person instinctively turns towards the source of the sound);
• Complaints of discomfort, noise or ringing in the ears;
• Complete absence of any emitted sounds in infants (with congenital hearing loss).

Degrees of deafness (hard of hearing)

Degrees of deafness (hard of hearing) reflect how severely a person’s hearing has deteriorated. Depending on the ability to perceive sounds of varying volumes, the following degrees of severity of hearing loss are distinguished:

• I degree – mild (hearing loss 1)– a person cannot hear sounds whose volume is less than 20–40 dB. With this degree of hearing loss, a person hears whispers from a distance of 1–3 meters, and normal speech from 4–6 meters;
• II degree – average (hearing loss 2)– a person cannot hear sounds whose volume is less than 41–55 dB. With average hearing loss, a person hears speech of normal volume from a distance of 1 - 4 meters, and whispers - from a maximum of 1 meter;
• III degree – severe (hearing loss 3)– a person cannot hear sounds whose volume is less than 56–70 dB. With average hearing loss, a person hears speech of normal volume from a distance of no more than 1 meter, but no longer hears whispers at all;
• IV degree – very severe (hearing loss 4)– a person cannot hear sounds whose volume is less than 71–90 dB. With moderate hearing loss, a person has difficulty hearing speech at normal volume;
• V degree – deafness (hearing loss 5)– a person cannot hear sounds whose volume is less than 91 dB. In this case, the person hears only a loud scream, which normally can be painful to the ears.

How to determine deafness?

To diagnose hearing loss and deafness at the initial examination stage, a simple method is used, during which the doctor whispers words, and the person being examined must repeat them. If a person does not hear whispered speech, then hearing loss is diagnosed and further specialized examination is carried out aimed at identifying the type of pathology and clarifying it possible reason, which is important for the subsequent selection of the most effective treatment.

To determine the type, degree and specific characteristics of hearing loss, the following methods are used:

• Audiometry(examines a person’s ability to hear sounds of different pitches);
• Tympanometry(examines bone and air conduction of the middle ear);
• Weber test(allows you to identify whether one or both ears are involved in the pathological process);
• Tuning fork test - Schwabach test(allows you to identify the type of hearing loss - conductive or sensorineural);
• Impedancemetry(allows us to identify the localization of the pathological process that led to hearing loss);
• Otoscopy(examination of ear structures with special instruments in order to identify defects in the structure of the eardrum, external auditory canal, etc.);
• MRI or CT scan (the cause of hearing loss is revealed).

In each specific case, to confirm hearing loss and determine the degree of its severity, it may be necessary different quantities examinations. For example, audiometry will be enough for one person, while another will have to undergo other tests in addition to this examination.

The biggest problem is identifying hearing loss in infants, since they, in principle, do not yet speak. In relation to infants, adapted audiometry is used, the essence of which is that the child must respond to sounds by turning the head, various movements, etc. If the baby does not respond to sounds, then he suffers from hearing loss. In addition to audiometry, impedance measurements, tympanometry and otoscopy are used to identify hearing loss in young children.

Treatment

General principles of therapy

Treatment of hearing loss and deafness is complex and consists of carrying out therapeutic measures aimed at eliminating the causative factor (if possible), normalizing ear structures, detoxification, and also improving blood circulation in the structures of the auditory analyzer. To achieve all goals of hearing loss therapy, use various methods, such as:

• Drug therapy(used for detoxification, improving blood circulation in the brain and ear structures, eliminating the causative factor);
• Physiotherapeutic methods(used to improve hearing, detoxification);
• Hearing exercises(used to maintain hearing levels and improve speech skills);
• Surgical treatment(surgeries to restore the normal structure of the middle and outer ear, as well as to install a hearing aid or cochlear implant).

For conductive hearing loss, the optimal treatment, as a rule, is surgical treatment, which results in the restoration of the normal structure of the middle or outer ear, after which hearing is completely restored. Currently, to eliminate conductive hearing loss, a wide range of operations are performed (for example, myringoplasty, tympanoplasty, etc.), among which, in each specific case, the optimal intervention is selected to completely eliminate the problem that is the cause of hearing loss or deafness. The operation allows you to restore hearing even with complete conductive deafness in the vast majority of cases, as a result of which this type of hearing loss is considered prognostically favorable and relatively simple in terms of treatment.

Sensorineural hearing loss is much more difficult to treat, and therefore all possible methods and their combinations are used to treat it. Moreover, there are some differences in the tactics of treating acute and chronic sensorineural hearing loss. Thus, in case of acute hearing loss, a person must be hospitalized as soon as possible in a specialized department of the hospital and undergo drug treatment and physical therapy in order to restore the normal structure of the inner ear and, thereby, restore hearing. Specific treatment methods are selected depending on the nature of the causative factor (viral infection, intoxication, etc.) of acute sensorineural hearing loss. With chronic hearing loss, a person periodically undergoes courses of treatment aimed at maintaining the existing level of sound perception and preventing possible hearing impairment. That is, for acute hearing loss, treatment is aimed at restoring hearing, and for chronic hearing loss, treatment is aimed at maintaining the existing level of sound recognition and preventing hearing deterioration.

Therapy for acute hearing loss is carried out depending on the nature of the causative factor that provoked it. Thus, today there are four types of acute sensorineural hearing loss, depending on the nature of the causative factor:

• Vascular hearing loss– provoked by circulatory disorders in the vessels of the skull (as a rule, these disorders are associated with vertebrobasilar insufficiency, hypertension, strokes, cerebral atherosclerosis, diabetes mellitus, diseases of the cervical spine);
• Viral hearing loss– provoked by viral infections (infection causes inflammatory processes in the area of ​​the inner ear, auditory nerve, cerebral cortex, etc.);
• Toxic hearing loss– provoked by poisoning with various toxic substances (alcohol, industrial emissions, etc.);
• Traumatic hearing loss– provoked by skull injuries.

Depending on the nature of the causative factor of acute hearing loss, the optimal medications for its treatment are selected. If the nature of the causative factor could not be accurately established, then by default acute hearing loss is classified as vascular.
pressure Eufillin, Papaverine, Nikoshpan, Complamin, Aprenal, etc.) and improving metabolism in the cells of the central nervous system (Solcoseryl, Nootropil, Pantocalcin, etc.), as well as preventive inflammatory process in brain tissue.

Chronic sensorineural hearing loss is treated comprehensively, periodically conducting courses of medication and physiotherapy. If conservative methods are ineffective, and the hearing loss has reached grade III-V, then surgical treatment is performed, which consists of installing a hearing aid or a cochlear implant. Among medications for the treatment of chronic sensorineural hearing loss, B vitamins (Milgamma, Neuromultivit, etc.), aloe extract, as well as drugs that improve metabolism in brain tissue (Solcoseryl, Actovegin, Preductal, Riboxin, Nootropil, Cerebrolysin, Pantocalcin, etc.) are used. ). Periodically, in addition to these drugs, Proserin and Galantamine, as well as homeopathic remedies (for example, Cerebrum Compositum, Spascuprel, etc.) are used to treat chronic hearing loss and deafness.

Among the physiotherapeutic methods for the treatment of chronic hearing loss, the following are used:

• Laser irradiation of blood (helium-neon laser);
• Stimulation with fluctuating currents;
• Quantum hemotherapy;
• Endural phonoelectrophoresis.

If, against the background of any type of hearing loss, a person develops disorders of the vestibular apparatus, then H1-histamine receptor antagonists are used, such as Betaserc, Moreserc, Tagista, etc.

Surgical treatment of deafness (hearing loss)

Surgeries are currently being performed to treat conductive and sensorineural hearing loss and deafness.

Surgeries to treat conductive deafness involve restoring the normal structure and organs of the middle and outer ear, allowing the person to regain hearing. Depending on which structure is being restored, the operations have appropriate names. For example, myringoplasty is an operation to restore the eardrum, tympanoplasty is the restoration of the auditory ossicles of the middle ear (stapes, malleus and incus), etc. After such operations, as a rule, hearing is restored in 100% of cases.

There are only two operations for the treatment of sensorineural deafness: installation of a hearing aid or cochlear implant. Both options for surgical intervention are performed only if conservative therapy is ineffective and with severe hearing loss, when a person cannot hear normal speech even at close range.

Installing a hearing aid is a relatively simple operation, but, unfortunately, it will not help restore hearing to those who have damage to the sensitive cells of the cochlea of ​​the inner ear. In such cases effective method Hearing restoration is the installation of a cochlear implant. The operation to install an implant is technically very complex, therefore it is performed in a limited number of medical institutions and, accordingly, is expensive, as a result of which it is not accessible to everyone.

The essence of a cochlear prosthesis is as follows: mini-electrodes are introduced into the structures of the inner ear, which will recode sounds into nerve impulses and transmit them to the auditory nerve. These electrodes are connected to a mini-microphone placed in the temporal bone, which picks up sounds. After installing such a system, the microphone picks up sounds and transmits them to electrodes, which, in turn, recode them into nerve impulses and send them to the auditory nerve, which transmits signals to the brain, where sounds are recognized. That is, cochlear implantation is, in essence, the formation of new structures that perform the functions of all ear structures.

Hearing aids for the treatment of hearing loss

Currently, there are two main types of hearing aids: analog and digital.

Analog hearing aids are familiar devices that are visible behind the ear of older people. They are quite easy to use, but cumbersome, not very convenient and very crude in providing amplification of the sound signal. You can purchase an analog hearing aid and start using it yourself without special settings from a specialist, since the device has only a few operating modes, which are switched using a special lever. Thanks to this lever, a person can independently determine the optimal mode of operation of the hearing aid and use it in the future. However, an analog hearing aid often creates interference and amplifies different frequencies, not just those that a person cannot hear well, as a result of which its use is not very comfortable.

A digital hearing aid, unlike an analog one, is adjusted exclusively by a hearing care specialist, thanks to which it amplifies only those sounds that a person cannot hear well. Thanks to the precision of the adjustment, a digital hearing aid allows a person to hear perfectly without interference and noise, restoring sensitivity to the lost spectrum of sounds without affecting all other tones. Therefore, in terms of comfort, convenience and accuracy of correction, digital hearing aids are superior to analogue ones. Unfortunately, to select and configure a digital device, you must visit a hearing care center, which is not available to everyone. Currently, there are various models of digital hearing aids, so you can choose the best option for each individual person.

Treatment of deafness using cochlear implantation: device and principle of operation of a cochlear implant, commentary from a surgeon - video

Sensorineural hearing loss: causes, symptoms, diagnosis (audiometry), treatment, advice from an otolaryngologist - video

Sensorineural and conductive hearing loss: causes, diagnosis (audiometry, endoscopy), treatment and prevention, hearing aids (opinion of an ENT doctor and audiologist) - video

Hearing loss and deafness: how the auditory analyzer works, causes and symptoms of hearing loss, hearing aids (hearing aids, cochlear implantation in children) - video

Hearing loss and deafness: exercises to improve hearing and eliminate ringing in the ears - video

Before use, you should consult a specialist.

Sensorineural hearing loss is damage to the hearing organ caused by a dysfunction in the signal reception function of the sound-receiving apparatus located in the middle of the inner ear. The development of this pathology can be caused by several factors. The most common causes of sensorineural hearing loss are: destruction of the structure of the middle ear, atrophy of the cochlear nerve ending, damage to the cerebral cortex in the centers that are responsible for processing sound signals coming from the environment.

Sensory hearing loss is determined using a special Weber test. The tuning fork emits characteristic vibrations, and at this moment the doctor touches the bones of the patient’s skull along the midline of their location. A patient who is suspected of having this pathology of the hearing organ must report what sounds he hears directly when the tuning fork is sounded near the ear, and when the device is applied to the skull. So, the otorhinolaryngologist determines the degree of conductivity of sound signals, and how active the nerve connecting the inner ear and the brain's hearing center is.

The diagnosis of sensory hearing loss includes several degrees, namely four, each of which is characterized by a specific clinical picture of the disease.

• Sensorineural hearing loss 1st degree. The conductivity threshold for audio signals is 50 dB.
• Sensorineural hearing loss 2 degrees. The patient is able to hear spoken speech with a sound range from 50 to 60 dB.
• Sensorineural hearing loss 3 degrees. It is already considered a severe form of the disease, since a person hears sounds with a volume of at least 60 - 70 dB. To do this, the interlocutor must be in close proximity to the person suffering from hearing loss and speak as loudly as possible.
• Sensorineural hearing loss 4 degrees. It is the most complex manifestation of sensorineural hearing impairment. This is actually complete deafness. Sounds can only be heard when they sound in the range from 70 to 90 dB.

In the presence of the last degree of the disease, traditional treatment with medications has a very insignificant effect. The best option is to select a high-quality hearing aid, taking into account the specifics of the disease.

Causes of development of sensorineural hearing defect

In most cases, impaired perception of sound signals is associated with dysfunction of the cochlear nerve inside the middle ear, or with defects in hair cells, which are unique sensors that capture the slightest vibrations of sound signals. Much less commonly, sensory hearing loss is caused by damage to the cerebral cortex in the area of ​​the centers responsible for hearing. It is worth understanding in more detail all the reasons for the development of this disease.

Neurosensory damage to the hearing organ is most difficult to treat when the function of the auditory analyzer is affected, so it is important to avoid noisy rooms so as not to injure this important element of the inner ear.

Congenital sensorineural hearing loss

Neurosensory hearing pathology is quite common in young children and has a congenital form of development. Sensory hearing loss in children can be caused not only by genetic abnormalities in the formation of the hearing organ, but also by the presence of many other harmful factors.

Defective development of the cochlear nerve in the inner ear.

Chromosome defects, which are responsible for the formation of elements of the hearing organ.

Congenital tumor in the middle ear, surgical removal of which can lead to destruction of the entire structure of the hearing organ itself.

Fetal alcohol dependence. Medical statistics say that if during pregnancy the mother systematically drank alcohol and suffered from alcoholism, then there is a 64% chance that the child will have congenital hearing loss. This effect on the baby’s auditory nerve is exerted by toxic substances formed during the decomposition of the components that make up alcoholic drinks.

Premature birth. Approximately 5% of newborn children have sensorineural hearing loss due to the fact that the cochlear nerve simply has not had time to fully form.

Chlamydia. If this infection is transmitted from mother to child, it can cause damage to the auditory nerve.

Syphilis. This bacterial pathogen is also transmitted from a pregnant mother to her baby in the womb, and the likelihood that the child will be born completely deaf is 30%.

Rubella. Women carrying a child under their hearts should stay as far as possible from public places where outbreaks of this virus have been recorded. For adults, rubella is actually safe, but it has a negative effect on the development of the fetus. If a child, while still inside the mother, becomes infected with rubella, then in addition to neurosensory damage to the organ of hearing, eye disease occurs and a heart defect develops.

These unfavorable factors are the primary sources of congenital sensorineural hearing loss in children, which all responsible parents should be aware of.

Acquired sensorineural deafness

In addition to hereditary and congenital types of hearing loss, deafness is quite common, which was acquired by a healthy person throughout life due to the presence of certain circumstances. It is worth paying more serious attention, which can lead to hearing loss.

It is important to remember all these harmful factors that can cause hearing loss in completely healthy people.

Classification of sensorineural deafness

Based on the type of manifestation, hearing loss is divided into separate types, which are determined by an otorhinolaryngologist during an examination of the patient. When diagnosing hearing loss, it is important to correctly qualify the type of disease so that the treatment is as effective as possible and the patient’s hearing organ is restored as soon as possible.

Acute sensorineural hearing loss. It develops rapidly and is mainly provoked by bacterial and viral infections that cause inflammation inside the middle ear and in the cerebral cortex. In some cases, acute inflammation of the auditory nerve is possible, but this disease manifests itself extremely rarely.

Chronic sensorineural hearing loss. As a rule, it occurs after untreated ear diseases that have turned into sluggish inflammation. The disease may not manifest itself for a long period of time, but a person is diagnosed with otitis media consistently once or twice a year, and there is also a gradual decrease in hearing.

Bilateral sensorineural hearing loss. We are talking about damage to both sides of the inner ear, as a result of which deafness in both ears is diagnosed.

Unilateral sensorineural hearing loss. If a person cannot hear in one ear, and the reason is insufficient conduction of sound signals by the cochlear nerve to the cerebral cortex, then the patient is given this diagnosis.

Each of these types of disease is dangerous to human health, since if it develops further, it can progress and lead to much more serious complications.

Treatment of sensorineural hearing loss

Previously, treatment of sensorineural hearing loss with the use of traditional medications practically did not bring the desired effect. The only way to help the patient was to properly organize the selection of a high-quality device to amplify sound signals. The hearing aid was installed behind the outer part of the auricle. This practice is still used today, and signal amplification devices have become more modern, stylish, and also small in size. The patient is given the second disability group.

Treatment of sensorineural hearing loss in modern medicine has stepped forward.

Doctors have learned to perform surgical operations, the main purpose of which is to install cochlear implants, which stimulate the functioning of the damaged or atrophied auditory nerve. This technique has already proven its effectiveness, but is still at the development stage. Doctors in the field of otorhinolaryngology and surgery will have to refine the technology of operations to minimize risks for patients.

Diseases of the auditory nerve and nerve cells inner ear disorders lead to disruption of the transmission of nerve impulses from the inner ear to the brain. The patient develops a disease that results in hearing loss - sensorineural hearing loss.

The disease progresses over time, progressing to stage 4 development. In addition to hearing loss - hearing loss, changes in the vestibular apparatus are observed. The patient feels dizzy, loses coordination, experiences vomiting and nausea.

Treatment of sensorineural hearing loss 1st degree

The goal of treatment is to restore hearing. And the earlier diagnosis and therapeutic measures are carried out, the greater the patient’s chances for a favorable course of sensorineural hearing loss. It is advisable to start treatment already at stage 1 of the disease.

In the initial stages of sudden acute hearing loss, it is possible not only to stop the process, but also to partially restore hearing. Drug therapy gives good results. The patient is recommended inpatient treatment, adherence to a sound regime, sleep, balanced nutrition, and rest. Required condition improving hearing - quitting smoking and alcohol.

Drug therapy

The drugs should not be ototoxic or harmful to hearing. For the treatment of sensorineural hearing loss, medications are prescribed:

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

Drotaverine is one of the drugs for stage 1 disease

• antihistamines - suprastin, tavegil;
• means against intoxication of the body - reopolyglucin, hemodez;
• drugs for cerebral circulation - Cavinton, Trental;
• vitamins B1 and B6, PP;
• fibrinolytics - streptokinase in NaCl solution i.v.

The drugs drotaverine and papaverine are prescribed to improve blood circulation and reduce spasms blood vessels head, inner and middle ear. The cost of the drugs does not exceed 30 rubles for 40 tablets.

Veroshpiron and hypothiazide remove excess fluid from the body, thereby reducing intracranial pressure and normalizing pressure inside the labyrinth. A package of veroshpiron containing 20 tablets costs no more than 100 rubles. The price of hypothiazide is within 100 rubles.

When choosing antibiotics, it is important to select drugs that do not have an ototoxic (hearing-impairing) effect. For sensorineural hearing loss, streptomycin, kanamycin, and neomycin are not prescribed.

Cavinton and trental regulate blood flow in the brain. Trental is prescribed according to the scheme, increasing the dosage. The cost for 60 tablets is no more than 400 rubles. Cavinton is sold in dark glass ampoules, the price of 10 pieces is no more than 310 rubles.

Streptokinase, which affects the process of thrombus formation and promotes blood thinning, is somewhat more expensive. The cost of the drug is from 2,200 to 2,800 rubles.

Physiotherapy

Methods	Number of sessions	Duration of exposure	duration of treatment
Electrical stimulation	10	30-50 minutes	15-20 days
Ear blowing	+	+	+
Pneumomassage	+	+	+
Hyperbaric oxygenation	+	+	+

Acute forms of sensorineural hearing loss (no more than a month from the onset of the disease) are treated with surgery.

Surgical intervention

The operation of transtymponal administration of dexamethasone is resorted to in cases of particularly painful tinnitus. Under local anesthesia Using an injection needle, they penetrate the eardrum into the inner ear and inject a dexamethasone solution. The patient should hold his head in a certain way for 20 minutes and not make swallowing movements.

Treatment of sensorineural hearing loss 2 degrees

Drug therapy

When treating hearing loss of the 2nd degree, they resort to the scheme described above, supplementing it with a drug that prevents hearing loss - idebenone. The drug is a low-molecular organic antioxidant that quickly penetrates the brain. To enhance stimulation of brain function, idebenone is prescribed together with vitamin E. The cost of 60 capsules of idebenone is 410 rubles.

Idebenone is a drug for the treatment of hearing loss of 2 degrees

Physiotherapy

At stage 2, sensorineural hearing loss is treated with physiotherapeutic procedures. The following have a positive effect on the patient’s condition:

1. acupuncture;
2. electroacupuncture;
3. microwave reflexology;
4. oxygen barotherapy;
5. endaural phonophoresis.

Hearing aids

With sensorineural hearing loss, the perception of high-frequency sounds is primarily impaired. The task of hearing aids in grades 3 and 2 of the disease is to selectively enhance high frequencies. Due to the miniature size of the device, an acoustic effect occurs in which amplified sound is returned to the microphone. In addition, there may be an effect of excessive amplification of low frequencies, creating discomfort for the patient.

Classification of hearing aids

Hearing aids can be installed in only one ear - usually the one that hears better is chosen, or in both in case of bilateral hearing loss.

1. By signal processing method
   Analog and digital hearing aids are available for sale. Modern analog devices differ from their predecessors, which can only amplify sound. Analog devices have learned to adjust the volume, timbre, have several channels, and the ability to program. Behind-the-ear and in-ear models have been developed, the cost of the devices is 3,000 - 5,500 rubles.
   A digital device processes the signal at the speed of a computer. With such a device, the patient clearly distinguishes sounds, does not experience discomfort, and easily adapts to society. Prices for digital hearing aids start from 6,200 rubles (Siemens) to 60,000 rubles (Widex).
2. By placement method:
   • BTE - placed behind the ear, complemented by an in-ear insert;
   • in-ear - installed in the ear canal, manufactured individually.

Treatment of sensorineural hearing loss 3 and 4 degrees

Grade 3 hearing loss cannot be treated medications and physiotherapy. The disease is treated with hearing aids and cochlear implantation.

The indication for implant installation is chronic sensorineural hearing loss that cannot be corrected with a hearing aid. The implant consists of a receiver - it is installed behind the ear to convert mechanical vibrations into electrical ones. Using a platinum thread, the receiver is connected to the auditory nerve, through which electrical signals are transmitted to the brain.

To analyze and encode signals, a speech processor similar in appearance to a hearing aid is installed behind the ear. The implant is installed once, the device works without replacement for the rest of its life. The cost of the operation is 1,300,000 rubles; for citizens of the Russian Federation, the implant is installed free of charge.

Surgical intervention

They resort to operations on the cochlea only in extreme cases. Operations are also performed to resection the tympanic plexus and remove the nerve ganglia - the upper cervical and stellate.