Konovalov S. Diagnostic and treatment optimization of hearing disorders in patients with extravasal compression of the vertebral arteries.

This paper studies the state of the auditory analyzer, cerebral hemodynamics and biochemical indicators of blood plasma, that the machine-building industry workers, exposed to in-plant noise.have. The purpose of the study is to improve the quality of diagnosis of sensorineural hearing loss based on a research of clinical, audiological, hemodynamic and biochemical indicators of noise-exposed workers with both normal hearing and various degrees of hearing disorders. The examination was made, and the results of studies of 115 noise-exposed workers with normal hearing and sensorineural hearing loss and 15 persons of control group were analyzed. In the study of otoacoustic emission indices of workers with normal hearing and initial sensorineural hearing loss, the amplitude decrease of the acoustic response UAE was observed, especially in the area of frequencies 4 and 6 kHz. Registration of partially positive test or lack of registration of otoacoustic emissions indicates dysfunction of curls functions. The received data of acoustic impedancemetry show a decrease of adaptive properties of the auditory analyzer of the workers studied. A significant (P<0,05) lengthening of the recession period of ARVM at contralateral stimulation is detected in the workers studied in group 2 compared to the control group. Significantly (P<0,01) the ARVM amplitude was reduced in patients of group 2, in both ipsy-and at contralateral stimulation. Time and amplitude acoustic impedancemetry indicators can be used as objective criteria to determine the state of adaptive properties of auditory system to the production of noise that exceeds the maximum permissible level. It is determined, that even at normal auditory function the violations of cerebral hemodynamics and lipid metabolism are revealed, that was displayed in the increased tone of cerebral vessels and the difficulty of venous outflow according to REG data, especially in the vertebral-basilar system. In workers with moderate and severe auditory function disabilities, according to sound perceptive type, in both carotid and vertebral-basilar systems of cerebral circulation were determined more significant changes than in workers with primary SNP. In addition, these changes in the auditory system and brain vessels go in parallel with disorders of lipid metabolism. Important role of the use of biochemical indicators of blood plasma for further development of early auditory and hemodynamic impairment in the production of noise is determined in workers with little length of service.