Petruk L. Diagnostics and treatment sensorineural hearing and vestibular disturbances in patients with acoustic trauma in area of combat actions

The dissertation is devoted to the problem of improving the quality of diagnostics and treatment of sensorineural hearing loss and vestibular disorders in cases when acoustic trauma received in the combat zone. Using the multifactorial analysis of data of complex clinical and instrumental inspection was proved that when a combat acoustic trauma occurs there are defeats of all - both peripheral (89,7%), and the central (100%) departments of the auditory analyzer, vestibular system (94,9%, mainly central vestibular syndrome 64.5%), and there are also significant extraaural changes (disorders of cerebral hemodynamics and functional changes of the CNS, 100%), and their characteristic features were identified. The important role of the state of the brainstem, subcortical and cortical departments of the auditory analyzer in the development of sensorineural hearing disorders in acoustic trauma obtained in real combat conditions has been proved. The most informative features were identified, including objective, acoustic traumatic lesions of the auditory and vestibular analyzers and extraaural changes according to the comprehensive clinical and instrumental examination and it's diagnostic and prognostic value were determined. Approaches to the complex treatment of sensorineural hearing loss due to the combat acoustic trauma have been improved. Protocols and the procedure for providing medical care for servicemen with combat trauma during the stages of medical evacuation (EME) have been developed and implemented in the work of medical institutions in the system of security and defense structures of Ukraine. The results of the research contribute to the early detection of disorders of auditory and vestibular function in cases when acoustic trauma obtained in the area of combat actions occurs and improve the quality of diagnostics and effectiveness of treatment.