Golod O. Clinical and audiological diagnostics optimisation of admix hearing loss in children

The thesis is devoted to diagnostics quality improvement at mixed hearing loss (MHL) in children with middle ear nonpurulent diseases with exudate (MENDE), acute (AO) and chronic (CO) otitis on the base of studying and comparative analysis of results of clinical and psychoacoustic researches, registration of temporary characteristics of shorty latent acoustical caused potentials (SLACP). The research is based on results of studying and comparative analysis of results of clinical and psychoacoustic researches, registration of SLACP temporary characteristics in 130 children with MHL and conductive hearing loss (CHL), been treated in SI "Institute of otorhinolaryngology named after prof. О.S. Kolomiychenko NAMS Ukraine" and children's center for hearing restoration. MHL was diagnosed in 102 children including 42 with MENDE (I group), 28 with AO (IIa group), and 32 with CO (IIb group). CHL was revealed in 28 children (III group or group of comparison). Control group was made of 20 conditionally healthy children with normal hearing, without pathology of ENT-organs. According to data of threshold voice-frequency audiometry, on osteal conduction hearing depression on tones in the range of 4 kHz was revealed in all patients with MHL, most expressed - in IIa and IIb 2 groups. Besides, in patients of the I group reliable (Р<0.01) rising of thresholds of hearing on tones in the range of 0,25 and 0,5 kHz in comparison with norm was noted. According to a speech and overthreshold audiometry the slowed-down augmentation of legibility of speech dough and its' paradoxical decrease at children with MHL were revealed. Thus, indicators of a subjective audiometry: hearing on tones on osteal conduction in the range of 4 and 6 kHz, and at MENDE - on frequency of 0,5 kHz, thresholds of 50% of legibility of numerals test on osteal conduction according to E.M. Harshak, paradoxical decrease and the slowed-down augmentation of legibility of speech dough are important signs of MHL. The scheme for SLACP registration in children with MHL was proposed. Unidirectional changes of SLACP characteristics were taped at different types of MHL: registration thresholds of the V wave of SLACP rising at air, osteal and tissue stimulation; augmentation of SLACP main peaks latent period at overthreshold stimulation at absence of reliable (Р<0.05) elongation of interpeak intervals; the characteristic type of "latence - intensity" functions at authentically smaller augmentation of the latent period of the V wave of SLACP, insignificant differences of registration thresholds at osteal and air stimulus presentation (respectively 15-20 and 20-35 dB). These signs can be objective criteria for MHL diagnostics in children.