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Section 5. Medical sciences
Arifov Sayfutdin Saydazimovich, Professor, Head of Otorhinolaryngology Department, Tashkent Institute of Postgraduate Medical Education, Tashkent, Republic of Uzbekistan E-mail: sarifov@mail.ru Orifov Salokhiddinkhon Sayfiddinovich, Aspirant of Otorhinolaryngology Department, Tashkent Institute of Postgraduate Medical Education, Tashkent, Republic of Uzbekistan E-mail: dr.arifov@mail.ru
CONDITION OF THE AUDITORY ANALYZER IN PATIENTS WITH ACUTE SENSORINEURAL HEARING LOSS AFTER ACOUSTIC TRAUMA
Abstract. The irrational use of sound-amplifying equipment and portable audio devices leads to the development of acute sensorineural hearing loss, especially among the young people.The results of examination of 9 patients aged 18 to 30 years with acute sensorineural hearing loss are presented. All patients have gone through a comprehensive clinical and audiological examination. The cause of acute sensorineural hearing loss of these patients was the irrational use of portable audio devices.
Keywords: sensorineural hearing loss, portable audio devices, headphones.
Introduction. The problem of acute sensorineural hear- of the sudden onset of hearing impairment with a sharp one-
ing loss (SNHL) is of great social importance, due to the widely spread prevalence of this disease. Current statistics indicate a steady upward trend in the incidences of acute SNHL worldwide [1; 2].
SNHL is considered as a single unit disease with a poly-etiological character. One of the common causes of SNHL is the effect of high intensity sounds on an auditory analyzer. According to World Health Organization (WHO), 1.1 billion young people (at the age of between 12 and 35) are at risk of hearing loss as a result of exposure to noise in places of recreation and entertainment.
Portable audio devices are now widely used, especially among young people and children. This fact is widespread in many countries of the world. The literature notes the highest risk of SNHL development in people who use headphones for three or more hours a day [2].
The above makes it relevant to study it in detail as a significant factor in the emergence of persistent acute SNHL.
Purpose. Analysis of the clinical and audiological manifestations of acute SNHL arising from the irrational use of portable audio devices.
Material and methods. The results of examination of 9 patients (the main group) are presented. In 3 (33,3%) patients had a diagnosis of "Bilateral acute sensorineural hearing loss" (H90.3 according to ICD-10) and 6 (66,7%) - "Unilateral acute sensorineural hearing loss" (H90.4 by ICD-10). The age of patients varied from 18 to 30 years old. Males accounted for 55.6% and females 44.4%. They pointed to the causal factor
time short-term increase in the volume of sound in the headphones, as a result of incorrect handling of the volume control function of the mobile phone when listening to music. The latter in all patients at the time of ascertaining acute acoustic trauma was at the maximum value of the volume level.
In the presence of past ear diseases or their detection at the time of examination, patients were not included to the study. The control group consisted of 9 healthy individuals.
All patients have gone through general otorhinolaryn-gological examination included rhinoscopy, pharyngoscopy, indirect laryngoscopy, otoscopy and audiological examination. The study of the hearing organ included: the study of complaints, history of disease and life, acoumetry, pure tone audiometry, audiometry in the extended frequency range of air conduction (in the range of 10000-16000 Hz), SISI-test, tympanometry, registration of transient evoked otoacoustic emissions - TEOAE.
The diagnosis of SNHL followed the International Statistical Classification of Diseases and Health Problems of the tenth revision (ICD-10). The international classification of hearing impairment was used to assess the degree of hearing loss (WHO, 1997).
Measurement of the output sound levels at the headphones was carried out using the device "artificial ear" type 4152 and devices for studying the sound level type 2235 (Bruel&Kjaer, Denmark).
Calculated the value of the criterion of reliability of differences (p) was tested using Student's t-test.
CONDITION OF THE AUDITORY ANALYZER IN PATIENTS WITH ACUTE SENSORINEURAL HEARING LOSS AFTER ACOUSTIC TRAUMA
Results and discussion. The study was performed at the ENT Department of the Tashkent Institute of Postgraduate Medical Education for the period from 2008 to 2018. Of the total number of patients, 78% used intra-channel vacuum headphones, the remaining 22% - overhead headphones.
In 36,4% patients had a diagnosis of "Bilateral acute sensorineural hearing loss" and 63,6% - "Unilateral acute sensorineural hearing loss". The predominance of unilateral hearing loss is due to the fact that most patients indicated that they used portable audio devices only on one ear. In a bilateral process, asymmetry in the degree of hearing impairment was not observed.
66.7% of patients with hearing impairment combined with tinnitus in the affected ear. In three cases, the noise had only a high-frequency character in the form of a whistle or a squeak, one - a low-frequency character in the form of a hum, and two patients noted a combination of several noises.
Hearing impairment at the level of I-IV degree of hearing loss was established in 9 patients. Their distribution, taking into account the degree of hearing loss, was as follows: the first degree - 50%, the second degree - 25%, the third and fourth degrees-25% each. In single case, it was found that the threshold increases only in the high-frequency zone (4000-8000 Hz) and the average level of hearing loss did not reach the minimum value of hearing loss of the first degree.
According to the pure tone audiometry, 9 patients had a descending character of audiograms, of which a slight-sloping - 40% and a steeply descending - 60% of cases.
According to the study of hearing in the extended frequency range audiometry, an increase the thresholds was observed by all patients, with the most highlighted at frequencies of 10000 and 16000 Hz. These changes were noted in one
patient with the slightlyincrease in the thresholds of only the high-frequency zone (4000-8000 Hz).
From 77.8% of patients the index of the SISI-test, over 70% were positive, which indicates a defeat of the cochlea receptors.
TEOAE was not registered in 88.9% of cases.Registered in one (11.1%) patient in which the hearing threshold was increased only in the high-frequency zone.
At the time of treatment of patients, the clinic measured the output sound pressure level (SPL) of all devices that caused the hearing impairment. The device "artificial ear" was used to measure of the SPL at the output of the earphone, while in the mobile phone the volume level was set to the maximum value. The average output SPL of the devices under study was 101.2 ± 1.7 dB (p < 0.01 relative to the maximum permissible noise level). The minimum figure was equal to 99.2 dB, the maximum - 103.6 dB.
Conclusion. The results show that the irrational use of portable audio devices has become the substantial cause for the development of acute SNHL.
With the irrational use of headphones, acoustic trauma in patients developed suddenly in response to short-term powerful sound effects.
This hearing impairment is characterized by varying degrees of hearing impairment and predominant damage of the cochlear receptors, as evidenced by the results of the pure tone audiometry, SISI-test, registration of TEOAE.
Audiometry in the extended frequency range can be an important method of examination in the diagnosis of hearing impairment in the presence of clinical and anamnestic data and the absence of changes from other hearing studies.
References:
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3. Henry P., Foots A. Comparison of user volume control settings for portable music players with three earphone configurations in quiet and noisy environments // J. Am. Acad. Audiol. 2012.- Mar.- No. 23 (3).- P. 182-191.
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