Sensorineural hearing loss - can it be treated or not, is it possible to stop hearing loss?

Among the different types of hearing impairment, sensorineural hearing loss (sensorineural, perceptual hearing loss) occupies a leading place in prevalence. It often occurs in older people, but in recent years this diagnosis has often been made at a younger age. This pathology is characterized by complete or partial hearing loss.

Degrees of hearing loss

Hearing loss refers to any weakening of hearing. There are 3 degrees of hearing loss:

• mild hearing loss (the hearing threshold rises to 40 decibels, speech differs at a distance of 4-6 meters);
• moderate hearing loss (hearing threshold from 41 to 50 decibels, a person perceives spoken language at a distance of 1 to 4 meters);
• severe hearing loss (hearing threshold up to 70 decibels, spoken speech can be heard from a distance of 1 meter).

Forms of the disease

First of all, there is a distinction between acute and chronic forms of sensorineural hearing loss. The first is determined if the symptoms of the disease manifest themselves within one month. Chronic form of the pathology - if the patient notes that the disease has developed for more than 30 days.

It is important to note that insufficient treatment or its absence, the acute form of sensorineural deafness quickly becomes chronic. In some cases, we can even talk about sudden deafness. When the symptoms of the disease appear in full intensity within a few hours.

In the medical community, it is also popular to divide sensorineural deafness into unilateral and bilateral. The first is noted when one ear is affected, the second when both ears are affected.

Diagnostic measures

The main diagnostic method is to assess the ability to perceive sounds of different volumes. An audiogram determines the degree to which these waves are perceived and helps determine the severity of the disease. This research method guarantees 100% accuracy of the final diagnosis.

The specialist may also order additional testing to identify the cause of hearing loss. It includes: neurological examination, impedance measurement, imaging methods to detect malignant neoplasms.

Treatment for late detection of the disease

In the case when two ears are damaged or a severe degree of hearing loss is revealed during hearing diagnostics, therapy consists of hearing aids. Which device should I choose? In particular, Siemens hearing aids are widely used today. The above treatment methods for severe hearing loss are no longer effective.

Therefore, it is important to know the symptoms of sensorineural hearing loss in order to recognize the disease in time. Let us remind you that the main ones are constant tinnitus, causeless dizziness, and problems with the vestibular apparatus.

To prevent things from coming to the point of purchasing expensive hearing aids or registering a disability for sensorineural bilateral hearing loss, you need to attend an appointment with an otolaryngologist at the first “alarm bells”. It is important! After all, with partial hearing loss, it is possible to restore it and cure hearing loss.

Array

Sensorineural hearing loss - diagnosis

If hearing loss is detected, it is recommended to consult a doctor as soon as possible to identify the causes. If sensorineural hearing loss is suspected, symptoms and treatment are the responsibility of the otolaryngologist and otoneurologist. A standard physical examination (for example, otoscopy) does not provide significant information; to establish a diagnosis of sensorineural hearing loss and determine the severity of the pathology, a number of special instrumental studies are required.

The following diagnostic tests are prescribed:

• tuning fork tests - carried out using a set of tuning forks with a certain duration of sound to assess bone and air conduction of sound;
• pure-tone audiometry – carried out using headphones and sound-reproducing equipment to determine the level of hearing acuity;
• acoustic impedance measurement – ​​reveals the localization and nature of disorders in the auditory system;
• vestibulometry is a series of tests that give an idea of ​​the functional state and level of possible damage to the vestibular analyzer.

Additional techniques that make it possible to identify causative and concomitant pathologies are:

• echocardiography;
• X-ray examination of the cervical spine;
• rheoencephalography;
• MRI or CT scan of the facial bones and brain;
• Ultrasound of the brachiocephalic arteries;
• General and biochemical blood test.

Causes

Sensorineural hearing loss is not only a decrease in hearing, but also difficulties in speech communication. It can be congenital or acquired. Scientists have discovered genes responsible for decreased hearing function.

With a dominant gene, hearing loss and deafness are hereditary, transmitted through generations. If it is recessive, then the manifestation of hearing loss will be selective in nature - not for everyone.

Symptoms of the disease

The first manifestation of sensorineural hearing loss is hearing loss, gradual and progressive, sometimes reaching complete deafness. The second typical symptom is the appearance of tinnitus. The noise is constant, subjective, high-frequency, can be described by the patient as a whistle, rustling, grinding in the ears. Tinnitus becomes the first reason to see a doctor.

In children

In young children, hearing loss manifests itself as an absence or questionable response to sounds, according to parents. The older the child becomes, the more pronounced the delay in mental and speech development is, the more difficult it is to carry out training. Attentive parents may notice changes in the behavior of a child with hearing loss during infancy.

In adults

Symptoms in adults may occur suddenly or may progress over months or years. Hearing loss is accompanied by the appearance of constant high-frequency noise in the ears. Possible autonomic symptoms: increased and decreased blood pressure, increased heart rate, increased sweating, nystagmus (quivering of the pupils of the eyes).

Conductive hearing loss

Conductive when the middle ear or eardrum is damaged as a result of mechanical trauma or infection.

Conductive hearing loss is a hearing impairment associated with poor perception of sounds, caused by dysfunction of sound conduction from the outer ear and eardrum to the middle ear and from it to the inner ear. That is why this type of hearing loss is called conductive – from the Latin word “to conduct”.

With conductive hearing loss, sound vibrations do not reach the main human receiving organ - the hairs of the epithelium of the organ of Corti located in the inner ear, which transmit signals to the auditory nerve.

Conductive hearing loss is characterized by reduced sensitivity in the perception of sounds, but there is no change in their clarity. It is enough to increase the volume and a patient with this form of hearing loss will hear normally. Typically, a person with conductive hearing loss speaks in a low voice and has normal ability to distinguish sounds, but has difficulty hearing when chewing.

Causes of conductive hearing loss

The causes of conductive hearing loss can be very diverse.

For example, it is often caused by wax plugs in the outer ear. Unfortunately, patients often try to get rid of such a traffic jam on their own, and often such amateur activity leads to serious injuries and inflammations, fraught with irreversible hearing loss.

Meanwhile, an experienced otolaryngologist at the MedicCity clinic can relieve you of cerumen impaction and the hearing loss it causes within a few minutes and without any discomfort.

Another common cause of conductive hearing loss is otitis externa, an inflammation in the outer ear, often accompanied by suppuration.

At the same time, attempts to treat otitis independently with the help of lotions and randomly selected medications can seriously aggravate the situation and dramatically complicate auditory perception, for a long time or even forever.

In addition, conductive hearing loss can be caused by the following eardrum-related causes:

• perforation or damage to the eardrum (may be accompanied by stabbing pain and bleeding);
• tympanosclerosis or sclerosis of the tympanic membrane is a pathological process of inflammation and degradation of the membrane tissue, accompanied by the formation of a purulent mass;
• anatomical anomalies of eardrum deformation.

These membrane conditions can be caused by injuries, thermal effects, infectious viral diseases, etc.

Sudden conductive hearing loss can also be caused by sudden changes in pressure on the eardrum, for example, when going underwater or into a mine, or when taking off on an airplane. In the middle ear, the consequences of acute and chronic otitis media - inflammation of the middle ear, as well as exudative otitis - can act as sound vibration blockers.

Finally, at the level of the inner ear, the causes of conductive hearing loss can be severe forms of otosclerosis and anatomical obstruction.

Classifications of the disease

Depending on the organ affected, hearing loss is classified into sensorineural, conductive and mixed.

Depending on the time of onset, sensorineural hearing loss can be acquired as a result of some exposure or congenital. Acquired is differentiated into several types with different clinical manifestations: sudden, acute, subacute and chronic.

On the affected side, unilateral and bilateral (symmetrical and asymmetrical) hearing loss are distinguished.

Sudden

In this form, the disease develops sharply, within 12 hours. The receptor apparatus of the cochlea quickly loses its function. When the exact cause of the complaints cannot be determined, idiopathic hearing loss is diagnosed.

Characterized by a sudden decrease in hearing in one or both ears, it becomes difficult for the patient to understand the speech of the interlocutor and the sounds of the environment, and sometimes complete deafness may occur. Constant subjective tinnitus, nausea, dizziness, increased sweating, and tachycardia may accompany hearing impairment.

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Mixed

Mixed hearing loss is a disease of both the prescription apparatus of the cochlea and the outer ear, that is, a combination of sensorineural hearing loss with conductive hearing loss.

Conductive

Conductive hearing loss is a hearing impairment in the presence of pathology in the outer, middle or inner ear, in which the conduction of sound vibrations to the cochlea is disrupted. The cause of this may be cerumen plug in the external auditory canal or chronic purulent otitis media. This mild to moderate hearing loss can be corrected with medication and surgery.

Neurosensory

Sensorineural deafness is caused by pathology of the sensitive apparatus of the cochlea (hair cells). In this case, a violation of sensory and neural functions occurs: the sound is not perceived and is not transmitted to the analyzer - the cortex of the temporal lobe of the brain.

Acute

In the acute form, hearing loss occurs quickly, within 1-3 days. The disease is reversible: within 1 month, hearing returns to normal. The acute form has a favorable prognosis - more than 90% of patients are completely cured.

Chronic

Hearing impairment persists for more than 3 months. In this case, hearing loss can be stable (the hearing level remains constant, without any dynamics), progressive (with gradual deterioration up to complete deafness), fluctuating (with periods of improvement). The chronic form is not amenable to conservative treatment; you can get rid of it only through cochlear implantation surgery (complete replacement of the cochlea).

Subacute

Subacute hearing loss involves hearing loss over a period of 1 to 3 months. With adequate therapy, complete restoration of hearing is possible in the future. In some patients, this form becomes chronic. The subacute form is treated in 30-40% of patients.

Functions of the hearing analyzer

From birth, a person is constantly surrounded by sounds of various natures. They report on all the processes taking place in the world. Sound travels continuously in the form of waves, which provoke the well-known auditory sensations. They are picked up by a paired auditory analyzer, in other words, by the ear. Loudness depends on the amplitude of the sound wave, and height depends on the frequency.

The human hearing organ consists of three parts: the outer ear, the middle ear and the inner ear. The first two are part of the sound conducting system. They are designed to capture wave vibrations and then transmit them to the inner ear. The latter is localized in the temporal bone. The internal part also has three components: the cochlea, its vestibular region and the semicircular canals. This is the sound-perceiving system of the auditory analyzer itself.

The anterior section is called the cochlea because of its unusual shape. It is completely filled with a liquid component, and inside there is a nervous apparatus (organ of Corti). It is covered with special hair cells. Perceiving auditory stimuli of various frequencies, they immediately convert them into an impulse and send them to the auditory nerve, or more precisely, to the cortical center. The latter is located in the brain. Here the impulse is processed.

Treatment

Treatment of sensorineural hearing loss is quite complex. It should be comprehensive, consistent, and begin as early as possible, preferably at the first stage of hearing loss.

In case of sudden onset of sensorineural hearing loss, emergency hospitalization and protective mode are indicated (exclude all loud noises and sounds). Subacute and chronic forms are treated on an outpatient basis (under the supervision of a clinic doctor).

For all forms of hearing loss, physical treatment is considered effective. Electrophoresis is used on the collar area with No-shpa, nicotinic acid, Euphyllin, magnesium, and Diphenhydramine. Physiotherapy helps improve blood circulation in the brain and activate nerve cells in the cervical spinal cord.

To reduce tinnitus, therapeutic massage of the collar, parotid and occipital zones, modulated currents to the cervical lymph nodes and carotid arteries are used. The restoration of damaged nerve fibers is facilitated by electrophoresis with B vitamins and balneotherapy (radon, sodium chloride baths). The ear is directly impacted using a vibroacoustic device, which activates blood and lymph flow.

Physiotherapy is carried out in 3-4 courses with a break of 2 weeks.

Cochlear implantation

This treatment method is used for severe bilateral hearing loss of stages 3-4, when the doctor understands that it is impossible to save the auditory receptors with medications. Instead of the affected cochlea, a special device is implanted that performs all its functions; the patient notes the restoration of hearing.

A cochlear implant consists of two parts: the outer one is attached above the ear and serves as a signal receiver, the inner one is installed directly in the ear and transmits the signal to the auditory nerve. The implantation operation is high-tech and should only be performed in qualified institutions.

Hearing aids

If there is mild or moderate damage to only one ear, hearing aid technology may be used to improve hearing. A special device picks up sounds from the external environment, converts them into waves and increases the volume, sending them to the middle ear. The hearing aid is attached to the ear and can be removed if necessary. After turning on the device, the patient begins to hear equally well in both ears.

Medication

In case of sudden onset of the disease, intravenous drugs are used in treatment: glucocorticosteroids, drugs that improve cerebral circulation, antioxidants, vitamins. After discharge from the hospital, the patient can be treated with tablet medications, which are taken in courses under the regular supervision of an ENT doctor.

In the chronic form, a course of medications to improve blood circulation 1-2 times a year is sufficient.

Folk remedies

To treat hearing loss, a decoction of hop cones, bay leaves, instillation of almond oil into the ear canal, and garlic and onion therapy were previously used.

However, traditional methods of treating sensorineural hearing loss have not proven effective in restoring hearing. When the first symptoms appear, you should immediately consult a specialist and not treat yourself.

Diagnosis and treatment of hearing loss

In the department of otorhinolaryngology of the multidisciplinary clinic "MedicCity" you will quickly and accurately be diagnosed using special diagnostic procedures and first-class equipment from the world's leading manufacturers.

A special study - audiometry - is aimed at determining the degree of hearing loss. This study also evaluates the effectiveness of treatment for hearing loss. Tuning fork tests and impedance measurements are also carried out .

Depending on the identified factors, one or another type of treatment is prescribed: conservative (taking anti-inflammatory drugs, physiotherapy - electrophoresis, phonophoresis, etc.), surgical (for example, removal of sclerotized tissue or correction of an anatomical defect).

Special procedures are used to clean the ear in case of suppuration, plugs, etc. A very common procedure for cleaning the auditory tube is by blowing it according to Politzer, using a special balloon.

We have also developed comprehensive treatment programs for sensorineural hearing loss.

general description

Sensorineural hearing loss (sensorineural hearing loss, cochlear neuritis) (H90) is a form of hearing loss in which any of the areas of the sound-receiving section of the auditory analyzer is affected.

Classification:

• Duration: acute - up to 1 month, subacute - up to 3 months, chronic - more than 6 months.
• According to the course: reversible, stable, progressive.
• Depending on the level of damage: peripheral and central.
• According to the degree of hearing loss: 1st degree (mild) - 26-40 dB, 2nd degree (moderate) - 41-55 dB, 3rd degree (moderately severe) - 56-70 dB, 4th degree (severe) - 71-90 dB, deafness - more than 90 dB.
• By etiology: congenital and acquired.

Causes:

• Infections (influenza, herpes, parainfluenza, measles, rubella, mumps, meningococcus).
• Intoxication with drugs (aminoglycosides, cytostatics, loop diuretics, salicylates), industrial/household substances.
• Vascular disorders: arterial hypertension, atherosclerosis, tendency to thrombosis, osteochondrosis Sh.O.P.
• Injuries: TBI, barotrauma, acute trauma.
• Long-term work in conditions of industrial noise and vibration.
• Allergy.
• Stress.
• Neuroma of the 8th pair of cranial nerves, Paget's disease, hypoparathyroidism, sickle cell anemia.
• Fetal hypoxia during pregnancy and childbirth, leading to damage to the central nervous system and hearing organ.
• Elderly age.
• Magnetic storms, changes in atmospheric pressure.

Prevention of hearing loss in adults

Primary prevention of sensorineural hearing loss consists of the following measures:

• Careful management of pregnancy, prevention of infectious diseases;
• Hearing protection in noisy environments;
• Timely treatment of ARVI, influenza, infectious diseases and their complications;
• Limiting the use of toxic medications and alcohol.

Even after effective treatment, hearing loss can return under conditions of stress, when the body is exhausted, and after a viral illness. That is why after treatment it is necessary to avoid factors that provoke exacerbation of the disease and take drugs that improve blood microcirculation.

Prevention

Audiological screening is used to prevent sensorineural hearing loss in children. In the first years of life, the child is examined at least twice by a pediatrician to assess his reaction to sounds. If parents notice the child’s lack of activity in response to sounds and noises that interest him, this should also be reported to the pediatrician. If hearing loss is suspected, the child is referred for consultation with a specialist - a pediatric otolaryngologist.

For adults, prevention consists of a protective hearing regimen: avoiding loud and prolonged sounds and timely treatment of inflammatory ear diseases. It is necessary to avoid trauma to the hearing organs, sudden changes in high and low atmospheric pressure, and exposure to intense vibration.

Preventive measures

In order not to think about how to cure hearing loss, you should follow some rules:

• avoid stress;
• lead a correct lifestyle;
• contact specialists in time for colds;
• avoid long stays in noisy places;
• increase immunity;
• Do not use sharp objects to clean your ears.

Causes of pathology

Note that sensorineural hearing loss can be either acquired or congenital. If you have a hereditary predisposition to this disease, then increased noise exposure can trigger its progression. For example, in the industrial premises where you work. This factor can lead to deterioration and even loss of hearing even at working age.

The disease often occurs in acquired form. In this case, the following can provoke its development:

1. Various common infectious diseases. Among them are influenza, scarlet fever, syphilis, etc.
2. Bacterial lesions of the auditory organs, as a result of otitis, labyrinthitis, meningitis.
3. Injuries to the external and internal structures of the ear.
4. Various toxic damage to the body.
5. Vascular diseases.

The provoking significance of all of these factors is that their impact leads to impaired blood circulation in the auditory organ and damage to the vessels supplying the auditory analyzer. And this already leads to hearing loss.

Traditional medicine recipes

It should be noted that treatment with folk remedies should not be perceived as the only correct and effective way to 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.
• Soak 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.

Diagnostics

Examining a patient for sensory hearing loss is a rather complicated process that requires the use of certain techniques. First of all, a specialist can assume the presence of a disease thanks to:

• patient complaints about difficult sound perception;
• the presence of certain reasons due to which hearing loss could develop, for example, previous illnesses or damage to the auditory nerve.

The most progressive methods for diagnosing abnormalities in the functioning of the auditory organs are:

• speech hearing testing;
• tuning fork examination;
• audiometry.

Otoscopy or the technique of examining the ear canal, used by many doctors when the patient complains of hearing impairment, will not give the desired results in the presence of sensorineural hearing loss.

Hearing impairment, starting from the second degree of hearing loss, can be identified through a simple conversation with a doctor.

Tuning fork study

One of the simplest methods for diagnosing a person’s hearing abilities. Using a low-frequency and high-frequency tuning fork, the doctor determines the type of violation. As a rule, the study allows us to clearly divide the causes of hearing loss into: the inability to transmit sounds and neurosensory impairment.

A tuning fork is a tool that allows you to generate sound waves of a reference frequency. There are mainly two types of tuning forks used in medicine: high-frequency and low-frequency. The most progressive methods for studying hearing capabilities using a tuning fork are:

1. Rinne test.
2. Weber test.

The first version of tuning fork diagnostics allows you to examine hearing for bone and air conduction. The Rinne test is as follows:

1. At the first stage, the tuning fork is activated and placed on the process behind the auricle. If the patient hears a sound, then bone conduction is normal.
2. After the patient stops hearing the tuning fork, the device is brought directly to the ear canal and air conduction is examined.
3. If the patient, after bringing a working tuning fork to his ear, hears a sound even for a second, then the result is positive. If the sound is not heard, then a negative test result is recorded.

The Weber test is somewhat simpler: as part of the test, the doctor activates a tuning fork and places it between the patient's ears. If the patient hears the sound equally on both sides, then the hearing is normal. If the patient hears sound waves in one of the ears more strongly than in the other, then there is a pathology.

The use of a tuning fork test makes it possible to preliminarily diagnose sensorineural hearing loss. However, additional studies may be required to fully confirm the diagnosis.

Audiometry

Hearing testing using audiometry allows you to obtain accurate information and diagnose most diseases of the human hearing system. All audiometry tests are carried out using a special device that generates sounds of a certain frequency. In most cases, threshold audiometry is used to diagnose sensorineural hearing loss.

The tonal procedure allows you to determine the subtlety of the patient’s auditory perception in the frequency range from 125 hertz to 8 kilohertz. Threshold audiometric testing is carried out in several stages:

1. The patient is placed in a quiet room.
2. The subject is given special headphones.
3. A sound of a certain pitch is sent into the patient's ear canal. If the subject is able to hear the sound, he presses a special button.
4. Hearing sensitivity is determined similarly.

The initial volume of sounds with threshold audiometry is 0 decibels. During the study, the volume increases to 110 decibels.

In order to clarify the results of a diagnostic study, other types of audiometry can be used:

1. Suprathreshold. This diagnostic technique shows the presence of damage to the receptors of the auditory nerve. In addition, a differential sound intensity threshold is determined.
2. Sensitivity to ultrasound. Audiometry of this type provides information about damage to the auditory nerve trunk.
3. Speech. The technique allows you to identify the patient’s capabilities during a normal conversation.

Additional studies are usually used to clarify the patient's condition. In medical recommendations, in addition to audiometry, it is recommended to conduct a computed tomography scan of the temporal region in order to exclude the presence of tumors.

Speech hearing test

The simplest test that does not require additional equipment. The study is carried out according to the following scenario:

1. The doctor moves six meters away from the subject. The patient is positioned with one ear in the direction of the doctor, and the second auditory wire is covered with the palm of his hand.
2. The specialist begins to pronounce words in which low sounds predominate, for example, norm, sea or window. After this, the doctor switches to voicing words with high sounds, for example, hare, cabbage soup, thicket.
3. If in one of the cases the patient could not hear the words, the doctor comes one meter closer.

The result is considered normal when the patient is able to hear words of whispered speech with low sounds from a distance of six meters and with loud sounds from 20 meters. Sometimes such a test does not give the required result. In this case, the doctor uses a study using spoken language.

Signs of hearing loss

The main symptom of the pathology is a decrease in the quality of hearing.

The higher the degree of hearing loss, the less sounds of different spectrums a person can distinguish. In mild forms of the disease, the patient ceases to perceive high and quiet sound waves.

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As hearing loss worsens, the next highest sound spectra disappear from audibility.

Diagnostic methods

Sensorineural hearing loss in adults is diagnosed based on the following research methods:

1. Anamnesis collection (suddenness of hearing loss that preceded the disease, presence of risk factors).
2. Otoscopy (examination of the outer ear is carried out using a device - an otoscope).
3. Acumetry (in a special noise-absorbing room, the doctor pronounces words at different volumes).
4. Audiometry (assessment of sound transmission through the air and through the temporal bone of the skull).
5. Magnetic resonance imaging of the bones and ligaments of the hearing organs and brain.
6. Laboratory blood tests, consultations with specialized specialists if necessary.

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In children, hearing impairment is assessed in a sound-absorbing room. The doctor pronounces sounds that are interesting to the child at different volumes (for example, the child’s name) and observes the reaction.

Assignment of disability

As for disability, it is always assigned when a patient is diagnosed with bilateral sensorineural hearing loss. Also, the patient acquires the status of “disabled” when he is diagnosed with fourth degree hearing loss. As for pediatric patients, they are assigned disability if either the third or fourth degree of the disease is diagnosed.

Types of disease

What is the ICD-10 code for sensorineural hearing loss? H90.6. This designation stands for “mixed bilateral sensorineural and conductive hearing loss.” Therefore, the disease has two types.

In the case of conductive hearing loss, the main problem is poor conduction of sounds by the middle and outer ears. This type of disease does not in any way affect the patient’s speech recognition. However, there is only one way to treat this hearing loss - surgery. Hearing is improved in two ways: by performing myringoplasty or by correcting the position of the auditory ossicles.

As for sensorineural hearing loss (ICD-10 code - H90.6), the cause of this disease is different. In damage to nerve cells in the inner ear or in the eardrum, damage to the auditory nerve. The causes of unilateral and bilateral sensorineural hearing loss are varied.

The disease can provoke a side effect from taking antibiotics. Often it becomes a consequence of infectious diseases. If the patient has been exposed to industrial noise for a long time, this can also provoke sensorineural hearing loss (bilateral or unilateral).

We should not forget about such a reason as a hereditary predisposition to hearing loss. It is dangerous because the disease does not bother a person for a long time, does not manifest itself in any way, and then a sharp deterioration in hearing occurs. Often, a genetic predisposition does not manifest itself in the direct descendants of the patient, but through a generation.

Etiology

The following reasons can lead to hearing loss:

1. Infection. Untreated colds cause complications in the ears: the auditory nerve becomes inflamed and hearing decreases. Etiological factors are viruses, bacteria and pathogenic fungi that can cause an acute process.
2. Inflammation of the inner ear and membranes of the brain - labyrinthitis, damage to the nerve cells of the inner ear, meningitis, inflammation of the inner ear with the formation of adhesions and scars.
3. Diseases of the nasopharynx - nasal infections, adenoids. Adenoid vegetations that do not disappear during adolescence enlarge and impair the patency of the auditory tube, which leads to hearing loss.
4. Taking ototoxic medications. These include antibiotics from the group of aminoglycosides - Gentamicin, macrolides, non-steroidal anti-inflammatory drugs - Aspirin, diuretics - Furosemide, antimalarial drugs. They impair hearing, which can recover after treatment.
5. Ear wax reduces hearing. The ENT doctor, having removed excess sulfur, will restore the patient’s hearing in a few minutes.
6. Occupational intoxication, as well as poisoning with lead, mercury, arsenic, and carbon monoxide can lead to hearing loss.
7. Stress is a common cause of sensorineural hearing loss.
8. Acoustic trauma and barotrauma. The cause of progressive hearing loss is prolonged exposure to a noise source. Exposure to traffic, household and industrial noise leads to hearing loss.
9. Mechanical injury. Traumatic brain injury caused by a fall can lead to slow hearing loss.
10. Allergy. One of the most common causes of hearing loss in children is allergic rhinitis, which is complicated by the development of chronic serous otitis media of the middle ear.
11. Benign and malignant neoplasms often cause hearing loss. These include acoustic neuroma and meningioma.

Senile hearing loss develops due to age-related changes occurring in the body. These include disorders of the blood supply to the inner ear, as well as vascular disorders - hypertension, atherosclerosis. These factors increase the susceptibility of older people to external pathogens. Hearing loss occurs gradually.

The causes of bilateral hearing loss are: stroke, sclerosis, brain injury or tumor, as well as syndrome of spontaneous decrease in cerebrospinal fluid pressure, tuberculous meningitis, sarcoidosis.

Damage to the auditory centers of the brain is associated with prolonged exposure to intense noise.

The causes of congenital hearing loss are: insufficient development of the cochlea of ​​the inner ear, congenital cholesteatoma, premature birth, chlamydia and syphilis in pregnancy, congenital rubella. Hearing impairment in newborns and young children is observed when a pregnant woman abuses alcoholic beverages and nicotine.

In autoimmune diseases, the body perceives the cochlea's own structures as antigens to which antibodies are produced. This is how inflammation develops, affecting the auditory analyzer and other organs.

Sensorineural hearing loss: causes of pathology development

Sensorineural hearing loss can be either an independent (not caused by anything) disease or accompany other diseases, contributing to the aggravation of the patient’s condition.

The main symptom of sensorineural hearing loss is a decrease in the number of sensitive nerve cells responsible for transmitting auditory impulses from the ear to the brain.

Most often, the process begins with the sensitive (hair) cells of the cochlea - a structure of the inner ear that picks up sounds from the external environment, converts them into nerve impulses and transmits them to the temporal cortex (hearing center).

The cause of hearing loss can be damage to the inner ear mechanically (accidental entry of foreign bodies into the ear canal) or due to a sharp difference in high and low atmospheric pressure (for example, during rapid immersion to depth), occupational hazards (working in conditions of constant loud noise in the absence of personal protective equipment).

In some cases, hearing loss may be the first manifestation of a benign or malignant tumor of the auditory nerve, when the transmission of nerve impulses to the brain becomes difficult.

There are several risk factors for the development of sensorineural hearing loss in adults:

• viral infections (influenza, mumps, measles, endemic encephalitis transmitted through tick bites);
• bacterial infections (meningitis, scarlet fever, typhoid fever, diphtheria);
• the influence of substances toxic to the hearing organ (industrial products, ototoxic chemicals, some antibiotics - Streptomycin, Kanamycin, Gentamicin, non-steroidal anti-inflammatory drugs, chemotherapy drugs for the treatment of cancer);
• diseases of the cardiovascular system, which can lead to thickening of the blood and a decrease in blood flow through the arteries of the brain (hypertension, stroke, angina);
• degenerative diseases of the spine involving the nerve roots of the cervical spine, which interfere with the normal conduction of nerve impulses to the brain.

In adults, deafness is often bilateral, since all risk factors affect the entire body. As first-line therapy in adults, a behind-the-ear blockade with a solution of Lidocaine or Proserin can be used to relieve symptoms.

The causes of sensorineural hearing loss in children can be divided into two groups: hereditary and non-hereditary.

Hereditary causes include mutations in genes encoding structural proteins of the inner ear. Defective cells appear that cannot perform their function. The result of these mutations is congenital deafness.

Non-hereditary causes of hearing loss in children are considered to be infections suffered in the prenatal period: cytomegalovirus infection, rubella, toxoplasmosis (a parasitic disease transmitted from cats), herpes, syphilis. The causative agents of these infections are ototoxic (negatively affect the structures of the ear), they are transmitted to the fetus from a mother who became ill during pregnancy. Infection of the fetus is especially dangerous in the first trimester of pregnancy, when all the child’s organs are forming.

In addition, hypoxic conditions at birth (eg, prolonged labor, premature rupture of membranes, umbilical cord entanglement), hyperbilirubinemia, and prematurity (birth before 32 weeks weighing less than 1500 g) may affect auditory function.

Congenital deafness in children can occur in both ears (bilateral) or in one ear (left-sided, right-sided).

Hearing aids

Sensorineural hearing loss of 3 degrees requires a different approach to treatment. In this case, hearing aids are most often used. Through special audiometric testing, the patient is individually selected for a device that significantly restores hearing.

To treat hearing loss, a special operation is used - cochlear implantation. The device performs the function of previously damaged hair cells, continuously providing electrical stimulation to the remaining auditory nerve fibers. This system includes a speech processor (outwardly similar to a hearing aid), a receiver (implanted subcutaneously) and chains of electrodes. A cochlear implant converts signals into electrical impulses and sends them to the auditory nerve. There are contraindications for such an operation, and after it a long recovery is required, the success of which depends on several factors.

Symptoms of sensorineural hearing loss and its signs

The main symptom of this disease is hearing loss. It can be unilateral or bilateral, sometimes accompanied by ringing in the ears and a feeling of fullness in the ears, sometimes even nausea and vomiting. In addition, hearing loss may be accompanied by dizziness and a feeling of unsteadiness (standing and walking).

Why does this disease occur? Causes of hearing loss in sensorineural hearing loss

why hearing loss occurs
This type of hearing loss can be congenital or acquired.

Congenital hearing loss may be a consequence of genetic failures: scientists have identified special genes responsible for hearing loss. In such cases, hearing loss or even deafness is hereditary, transmitted from generation to generation (if the gene is dominant) or not found in all children (if the gene is recessive).

Congenital hearing loss can also occur when the inner ear is underdeveloped. Since the inner ear and auditory nerves are formed in late pregnancy and are very sensitive to external damaging factors, many maternal diseases and other unfavorable factors can lead to sensorineural hearing loss and even deafness in children at the earliest stages of development.

Thus, with premature birth, the risk of hearing loss in a child increases to 5%. If a woman had rubella during pregnancy, the child will almost certainly develop hearing impairment.

That is why women are recommended to get vaccinated against rubella or it is useful for them to get sick with it before the onset of reproductive age and pregnancy. Also, maternal diseases such as alcoholism, syphilis and chlamydia can also lead to sensorineural deafness in the unborn child.

Acquired sensorineural hearing loss

However, most often sensorineural hearing loss is acquired, that is, it manifests itself throughout life - gradually or suddenly (acutely). Most often, this form of hearing loss affects people from 20 to 36 years old, mainly men.

Why does acquired NST occur?

The first possible cause is sound (or acoustic) trauma. It occurs after prolonged exposure to high-power sounds (more than 90 decibels). This happens if a person works in conditions of increased background noise or, for example, often attends music concerts, being close to sound speakers.

Another cause of deafness is mechanical trauma, which damages the structures of the inner ear, the auditory nerve or the auditory zone of the cerebral cortex.

However, perhaps the most common cause of acquired sensorineural hearing loss is hearing loss as a result of exposure to various harmful agents on the hearing organs. These include medications with ototoxic properties - that is, those that can have a harmful effect on the hearing organs. First of all, these are various groups of antibiotics (such as tobramycin), some diuretics (furosemide), as well as a number of other drugs, such as aspirin or methotrixate.

listening to loud music negatively affects hearing

In order to protect your hearing from such harmful influences, before taking medications you should carefully study the instructions for the drug.

Therefore, if you read in the section on side effects of a drug that it has a harmful effect on hearing and that the drug may cause a risk of hearing loss, it makes sense to consult with your doctor about the possibility of prescribing another drug that does not have ototoxic properties.

In some cases, together with a doctor, it is sometimes possible to find a treatment regimen in which medications are selected that do not have a harmful effect on hearing. Hearing loss in the form of varying degrees of sensorineural hearing loss can also be observed after suffering from various diseases.

These include viral diseases such as mumps, measles, rubella, herpes and influenza infections, as well as bacterial infections such as syphilis and scarlet fever. During the course of these diseases, complications may occur, which can manifest themselves in the form of hearing loss or even complete deafness.

To prevent the development of such complications, it is important to get vaccinated and not carry the disease on your feet, as is often the case, but at the onset of these infectious diseases, consult a doctor and begin full and serious treatment.

This attitude towards your health can help reduce the risk of sensorineural hearing loss after infections. In addition, purulent inflammation of nearby organs (for example, inflammation of the middle ear, purulent labyrinthitis) can spread to the area of ​​the inner ear, causing the same negative disorders.

We invite you to watch an interesting video about this disease and the anatomy of the inner ear:

How to distinguish sensorineural hearing loss from other types of hearing loss?

This task should only be solved by an otolaryngologist (ENT doctor). If you personally or one of your relatives show signs of hearing loss, especially acute ones (that is, hearing loss occurred acutely, over several days or even hours), do not self-medicate and contact a qualified and experienced ENT specialist as soon as possible. This will not only save your nerves from unnecessary worries, but perhaps help preserve your hearing!

Below there will be useful information on how to distinguish between different types of hearing loss, but we repeat: this information is given for informational purposes only, and only an otolaryngologist should diagnose diseases! So, one of the important tasks that a doctor faces is to distinguish sensorineural hearing loss from the so-called conductive hearing loss.

Their main difference is that with the first type of hearing loss, the sound-receiving organs (hair cells of the inner ear, auditory nerve, auditory zone of the cerebral cortex) are affected, and with the second, the sound-transmitting organs of the auditory sphere are affected: elements of the middle ear (the so-called auditory ossicles), outer ear or eardrum.

In addition, to determine this, the otolaryngologist performs the so-called Weber test, which allows you to determine whether the hearing loss is unilateral or bilateral and on which side the lesion is determined. This helps the doctor understand exactly what treatment tactics should be in this case of hearing loss.

Drug therapy

A disease such as sensorineural hearing loss should not be ignored. Treatment must be immediate, as its effectiveness depends on this. Treatment tactics are determined solely by the cause of the disease. This is especially true for patients with an acute form of pathology, in whom it is still possible to change the nervous tissue.

In the case of the infectious nature of the disease, antibacterial or antiviral therapy is indicated. In case of a toxic form, it is first necessary to remove toxins from the body. For these purposes, Reopoliklyugin and Hemodez are prescribed.

If the cause of the disease cannot be determined, the disease is considered as hearing loss of vascular origin. In this case, patients are prescribed drugs to normalize blood circulation (Vinpocetine, Piracetam, Cerebrolysin). Patients are also prescribed Trimetazidine. The medicine has antihypoxic and cytoprotective effects.

Glucocorticosteroids are used quite successfully in the fight against diseases such as sensorineural hearing loss. Treatment is carried out locally, which reduces the risk of side effects and at the same time allows you to achieve maximum effectiveness from the drug used. Additionally, some patients are prescribed diuretics, as well as B vitamins.

Restoration of hearing in this disease, as a rule, occurs partially. Deafness is caused by the death of fibers that are no longer capable of regeneration. All therapeutic measures are planned in such a way as to minimize the harmful effects of etiological factors and prevent the progression of the disease in the future.

Sensorineural hearing loss - treatment

How to treat sensorineural hearing loss depends on the data of clinical, instrumental and laboratory studies, the severity, duration and identified causes of the pathology. The treatment plan is individual for each patient. The main goals of treatment are to prevent the disease from becoming chronic, reducing the risk of hearing impairment, and, if the process is advanced, to prevent complete deafness and restore ear function to the extent possible.

Sensorineural hearing loss – can it be treated or not?

Sensorineural hearing loss remains a serious medical problem to this day. The most positive results of therapy can be achieved only if treatment is started on time.

According to statistics, if disorders occur suddenly and are mild or moderate, then after 3-4 months of treatment, complete elimination of the symptoms of the disease is achieved. In the chronic stage, therapeutic methods do not guarantee a cure.

Sensorineural hearing loss - clinical guidelines

When a diagnosis of sensorineural hearing loss is made, treatment in all cases includes compliance with the following recommendations:

• in the acute stage, immediate hospitalization in the otolaryngology department;
• protective auditory mode, excluding loud sounds (various noises, music, loud speech, and so on);
• giving up alcohol and smoking;
• eliminating stress;
• therapy of background somatic diseases.

Hearing restoration for sensorineural hearing loss

Conservative treatment of hearing loss is based on medication aimed at improving blood circulation in the intra-auricular vessels, increasing the functional activity of brain neurons, and enhancing the nutrition of nerve tissue.

The following drugs may be prescribed:

• neurometabolic stimulants (Vinpocetine, Cerebrolysin, Piracetam);
• angioprotectors (Pentoxifylline);
• glucocorticoids (Dexamethasone);
• antispasmodics (Papaverine, Drotaverine);
• antihistamines (Suprastin, Tavegil);
• diuretics (Veroshpiron, Hypothiazide);
• B vitamins.

A new, still experimental treatment method is the use of the drug Idebenone, originally developed for the treatment of Alzheimer's disease. This medication is a low-molecular organic antioxidant that can quickly penetrate the brain, exerting a trophic and metabolic effect there. To enhance brain stimulation, the drug is prescribed with parallel intake of vitamin E.

Sensorineural hearing loss, in addition to medication, requires physiotherapeutic treatment, which includes the following techniques:

• pneumomassage;
• electrical stimulation;
• hyperbaric oxygen therapy;
• endaural phonophoresis.

Sensorineural hearing loss – operations

In extreme cases, operations are performed to remove the tympanic plexus and nerve ganglia (upper cervical and stellate). An achievement of modern otosurgery is an operation called cochlear implantation. It is prescribed to those patients whose hearing loss is associated with a disorder of the organ of Corti (spiral), which is responsible for the perception of sounds using hair cells, and the nerve has not lost its functionality.

The intervention involves installing an electronic device in the cochlea of ​​the inner ear, replacing the affected part of the ear, so that surrounding sounds reach the auditory nerve and are normally perceived by the brain.

The structure of the device consists of several parts:

• external (located on the surface of the skin behind the auricle) – microphone, transmitter and speech processor;
• internal (implanted inside the ear on the bone) – receiver, stimulator and electrodes.

Incidence (per 100,000 people)

Types and degrees of hearing loss – sensorineural, conductive, mixed

There are 3 types of hearing loss:

• Neurosensory. It occurs as a result of damage to the inner ear after infectious diseases, vascular diseases, or injuries.
• Conductive. The causes of the disease lie in pathological changes, such as tumors and various damage to the hearing organs. This is also facilitated by inflammatory processes (external, otitis media) and age-related disorders.
• Mixed hearing loss. It is provoked by mixed reasons. Most often, this type cannot be treated.

Decreased hearing function is divided into several degrees, depending on functionality and the development of the disease. There are 4 stages of hearing loss.

A milder course of hearing loss is considered a disease of the first degree. In this case, there is only a slight deterioration in hearing. Symptoms practically do not appear. Patients perceive sounds quite well within the range of 26-40 decibels.

The second and third degrees of the disease are considered more severe. Additional symptoms appear, such as tinnitus, changes in the nature of speech. The patient distinguishes the sound range at 41-70 decibels.

The fourth stage is considered the most severe and can lead to permanent deafness. Sounds are practically not recognized by patients.

With timely treatment of grade 1 hearing loss, it is possible to achieve fairly good results and stop the further development of the pathology. At the first degree, a person perceives sounds spoken at a distance of up to 3-5 meters quite well. In the absence of adequate treatment, the symptoms worsen, speech in the presence of extraneous noise is not clearly perceived by the patient.

Why is treatment at Nearmedic convenient, reliable and effective?

Doctors at our center:

• They apply an individual approach to each patient, therefore they prescribe the diagnostic and treatment methods indicated only for him, and not everything in a row, as if according to a template;
• They work in a team, so if necessary, they immediately consult patients with related specialists in order to establish a true diagnosis;
• They constantly improve their qualifications at international symposia and congresses, which means they are aware of the latest medical advances in the field of hearing loss.

Nearmedic is a reasonable combination of quality medical services and affordable prices.

About the neurosensory variety

According to medical statistics, hearing problems are not uncommon. To one degree or another, 2% of the world's population suffers from them. And the most commonly diagnosed diagnosis is sensorineural hearing loss.

Most often, the disease is diagnosed in older people. But such a diagnosis is not uncommon among young people (including due to the fact that a hereditary predisposition to the disease may appear). Other names for this disease are perceptual or sensorineural hearing loss.

As the disease develops, a certain area of ​​the sound-receiving section of the hearing analyzer is affected. They could be the following:

1. Sensory structures and individual cells of the inner ear.
2. Middle ear.
3. Cortical section of the temporal lobe of the human cerebral cortex.

Sensorineural hearing loss also develops when the nerve cells of the inner ear, the auditory nerve, or the center of the nervous system are damaged. The disease is dangerous because if it is inadequately treated, improperly treated (or completely absent), it can lead to complete deafness. Moreover, such a pathological state of hearing is achieved in a short time. What is dangerous is that deafness in this case will be irreversible.

Rehabilitation period

After successful treatment for hearing loss, a person needs time to recover. The rehabilitation period lasts differently for everyone, depending on the duration of the disease, its degree and social life before therapy. Using a hearing aid improves hearing and allows the patient to correct his speech. Hearing aids for children contribute to the normal development of speech and psyche. The effectiveness of the hearing aid is checked two weeks after its installation. During this time, the person adapts to the sounds transmitted by the device and gets used to the unusual volume of speech.

Medical certificate

Cochlear neuritis is a disease of the inner ear caused by damage to the auditory nerve. The second name for the disease is sensorineural hearing loss. It is characterized by impaired perception of sounds due to pathology of the hearing aid. As it progresses, the lower threshold of hearing increases, which is why complete hearing loss cannot be ruled out. Often hearing loss leads to a disability group.

It is prevalent mainly among older people. However, in recent years, patients of working age have increasingly heard this diagnosis. The reason for this is the urbanization of the population and the constant noise pollution that accompanies people at work and at home.

A person may already be born with this pathology or begin to lose hearing in adulthood. Depending on the form of the disease, its causes vary.

Symptoms of hearing loss and deafness

There are many reasons for the appearance of hearing loss and deafness, and the symptoms of the disease depend on this. There are rare cases of asymptomatic disease. The main indicator of the presence of pathology is a decrease in hearing acuity. Other signs include:

• extraneous noise in the ears, squeaking, ringing, etc.;
• poor audibility of high frequency sounds;
• poor speech recognition in noisy environments;
• reduced permeability of sounds or its absence;
• body swaying, loss of coordination;
• sensation of movement of surrounding objects.

Indirect symptoms of deafness and hearing loss include:

• speech in high tones;
• incorrect placement of stress in words;
• lack of reaction to loud sounds;
• complaints of ringing in the ears;
• In newborns, the pathology manifests itself in silence; they do not coo, do not repeat sounds after adults, and do not turn their heads in search of the source of sounds.

People with hearing loss find it difficult to adequately perceive the world around them and conduct conversations with others, so they prefer a secluded lifestyle.

Reasons for appearance

Hearing loss can occur for the following reasons:

• Transmission of viral diseases, which in complex forms can negatively affect the hearing organs and reduce the level of perception of sounds. Diseases that can affect the functioning of the hearing organs include: scarlet fever;
• measles;
• flu;
• mumps;
• HIV infection.

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 turn, congenital pathology occurs:

• 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.

Causes of acquired disorder

As for acquired hearing loss, its causes lie in the following disorders

• Severe forms of infectious diseases - hearing loss in this case is a complication of an advanced disease.
• Injury to the inner ear from exposure to very loud sounds. The situation is observed among people who are near speakers at concerts or discos.
• Side effects of drugs or chemicals.
• Mechanical damage.

Loud sound causes acoustic injury

Pathologies associated with metabolic disorders - diabetes mellitus - can lead to the development of hearing loss. Vascular disorders can also have similar complications; this is due to impaired vascular tone or blockage. A person in this condition often experiences nutritional deficiencies.

How are diseases diagnosed?

The first step to getting a diagnosis is to visit a doctor. He will conduct a survey to determine factors that may have caused your hearing loss. These may be questions about inflammatory processes, bruises of the ears or head, extraneous noise in the ears, the presence of dizziness, changes in hearing depending on the situation.

At the second stage, a test is carried out to determine the patient’s perception of sounds of different volumes. The doctor whispers words from one side or the other and at different distances, and the patient must recognize and reproduce them. The ear canal is also examined with an otoscope for curvature and other defects in the canal or eardrum.

The degree of hearing impairment is shown by a tuning fork test. The doctor moves the device near the ear and determines in which position the patient hears better. Tests allow you to differentiate conductive and sensorineural pathologies.

Sound conduction is diagnosed by audiometry. This requires complete soundproofing of the room. Patients are exposed to sounds of different frequencies and volumes. They listen and say how they perceive them. This makes it possible to determine the degree of development of the pathology, as well as the area where sound conduction is impaired.

For young children, diagnostics are carried out in a playful way. Up to a year, sounds that can cause a reaction are the child's name, animal sounds, children's songs.

Diagnosis of hearing in a small child

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;
• the use of certain medications, 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 studies, residents of large cities often suffer from this disease.

Causes

Sensorineural hearing loss can be congenital or develop during life. Congenital hearing loss poses the greatest danger, since as a result of hearing impairment in children, the speech apparatus is not formed correctly, and difficulties arise with social adaptation and cognitive development. The most common causes of congenital hearing loss are:

• heredity;
• abnormalities in the development of the hearing system;
• infectious diseases of pregnant women;
• bad habits during pregnancy;
• premature birth;
• sexually transmitted diseases in the mother.

Loud music can cause hearing loss

Acquired hearing loss can develop as a result of:

• past infectious diseases (mumps, ARVI, influenza);
• chronic diseases of the cardiovascular system;
• exposure to high pressure on the eardrum;
• acoustic trauma (strong sound);
• stress;
• influence of industrial and household toxins;
• taking certain medications (aminoglycosides, diuretics, antimalarials, salicylates).

Hearing loss can develop gradually under unfavorable working conditions (high noise). This hearing impairment has its own definition - occupational sensorineural hearing loss. Noise-hazardous professions include miners, boilermakers, mechanics, blacksmiths, tinsmiths, polishers, aircraft mechanics, miners, and DJs.

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.

Congenital hearing loss

The main cause of the congenital form of sensorineural hearing loss is considered to be mutations in the genome. Scientists have discovered several genes that are responsible for hearing loss. In addition, the pathology may be hereditary. It is diagnosed in each new generation or observed after 1-2 generations.

Underdevelopment of the elements of the cochlea in a child may play a certain role in the etiology of the disease. The inner ear, together with the fibers of the auditory nerve, is formed in the fetus in the third trimester of pregnancy. These structures are especially sensitive at this stage to external and internal influences. An unbalanced diet, frequent stress and poor ecology can provoke disturbances in the formation of the child’s hearing organs.

Premature birth increases the risk of hearing loss in a newborn by up to 5%. If a woman has rubella during pregnancy, the baby will probably be born with a pathology of the auditory analyzer. Therefore, even at the planning stage, expectant mothers are recommended to be vaccinated against this virus.

Degrees of pathological condition

When choosing treatment, the degree of sensorineural hearing loss plays an important role. Hearing loss, regardless of the type and form of its course, goes through 4 stages of development, each of which has a different duration and clinical picture.

First degree

Sensorineural hearing loss of 1st degree is characterized by a decrease in the hearing threshold to 25-40 dB. At this stage, the disease remains unnoticed, since the person continues to distinguish normal speech at a great distance - up to 6 m, and quiet speech - up to 3 m. Difficulties can arise only when extraneous noise appears, which significantly reduces the distance between the interlocutors.

Second degree

Sensorineural hearing loss of the 2nd degree during an audiometric study is diagnosed by reducing the ability to perceive sounds with a strength of up to 40-55 dB. At this stage of development of the pathology, the patient perceives the speech of the interlocutor at a great distance much worse. For comfortable communication, it is necessary to approach a distance of no more than 4 m, when quiet speech can only be heard at a distance of 1 m.

Stage 2 hearing loss syndrome forces a person to frequently ask questions and strain their hearing while talking on the phone. With a one-sided form of sensorineural deafness, the patient hears better with the healthy organ, so during communication he tries not to face the side with the affected ear towards the interlocutor.

Third degree

Sensorineural hearing loss of the 3rd degree is characterized by serious disturbances in the functioning of the vestibular-cochlear tissues, which is associated with difficult-to-reversible degenerative processes of the sound-receiving apparatus or nerve fibers. During audiometry, the hearing threshold reaches 70 dB.

At this stage, the patient ceases to hear whispers and quiet speech. For comfortable communication, it is necessary to maintain a distance of no more than 2 m from the interlocutor. A person with impairment of the vestibular-cochlear apparatus of the 3rd degree constantly asks again and does not perceive rapid speech. This together creates great difficulties in communication, so the patient is prescribed sound-amplifying devices.

Fourth degree

Sensorineural hearing loss of 4 degrees is a serious illness in which a person does not perceive sounds with a strength below 90 dB (screams). At this stage, conservative therapy is ineffective - wearing sound-amplifying devices or surgical intervention is indicated to eliminate defects in the middle section, installing prostheses that replace damaged sections of the vestibulocochlear organ.

Pathology treatment methods

The doctor prescribes the method of therapy based on the results of the diagnosis. Treatment is aimed at:

• eliminating the causes;
• relieving inflammation;
• restoration of the structures of the outer and inner ear;
• improved blood circulation;
• detoxification of the body.

There are two methods of getting rid of pathology: conservative and surgical. In the first case, the following therapeutic measures are applied:

• electrical stimulation - electric current improves the functioning of the stapedius muscle, V, VII and X nerves, inner ear;
• taking opioid and neurosensory peptides from human blood serum;
• taking biostimulating serums and antioxidant drugs. The drugs help restore damaged ear structures.

If conservative treatment does not bring results or is not applicable for some reason, surgical intervention is prescribed. There are two types of operations used depending on the causes of the pathology.

1. If the cause of hearing loss is a violation of the auditory ossicles, then an operation to replace them is performed. Replacing with synthetic analogues allows you to improve the mobility of the bones and improve the patient’s hearing.
2. If hearing loss is caused by violations of the integrity of the eardrum, then myringoplasty is performed, replacing the organ with a synthetic one.

In addition, there are many folk remedies that can complement the range of measures to restore hearing.

Treatment of hearing loss with hearing aids

Forms of pathology

Based on the nature of development, it is customary to distinguish between acute, sudden and chronic forms of sensorineural hearing loss. The acute form of the pathology develops as a result of an infectious disease. The initial sign of hearing loss will be a decrease in hearing; the patient rarely immediately notices a decrease in acuity. The patient loses the ability to clearly recognize sounds, and his hearing threshold decreases.

The acute form is bilateral - the pathology affects both ears. Among other signs of this pathology are:

• distorted perception of sounds;
• noise in ears;
• coordination problems;
• stuffy ears.

The pathology in question practically does not cause patients to complain that their ears hurt. People with this pathology are forced to ask the interlocutor again, so it is difficult for them to communicate in a company or attend various cultural events. Telephone communication also becomes problematic.

Sudden hearing loss is characterized by the fact that the formation of the pathological process occurs quite quickly. After the first signs appear, complete or partial hearing loss occurs within 24 hours. If treatment measures are taken in a timely manner, the full functioning of the hearing aid can be restored.

The chronic form of hearing loss poses the greatest danger. It is characterized by a sluggish and slow course. Therefore, patients ignore hearing loss and do not seek medical help. And the disease progresses steadily, and the chances of completely restoring hearing are reduced. With this form of the disease, disability is not excluded.

Causes and risk factors

Hearing problems can be hereditary. In addition, they can be purchased during your lifetime. In the second case, deafness can develop under the influence of the following factors:

• infectious diseases - influenza, syphilis, acute respiratory viral infections, infectious form of mumps;
• vascular disorders - cerebral atherosclerosis or hypertension;
• stress;
• ototoxic effect of harmful substances or medications - these include aminoglycosides, diuretics, salicylates;
• traumatic injuries.

What should patients know about the treatment of sensorineural hearing loss?

There are important principles, adherence to which is very important for successful treatment. Here they are

First: if acute—suddenly occurring—hearing loss occurs, you should immediately consult an otolaryngologist or audiologist. The longer a patient with hearing loss goes without treatment or tries to treat himself, the less likely he is to preserve his hearing!

Second: sensorineural hearing loss should be treated only in a specialized hospital. As a rule, only there there is all the necessary equipment for quick diagnosis of hearing conditions, and, in addition, competent specialists with extensive experience in treating such diseases work there.

Third: when treating sensorineural hearing loss, a protective regime is very important. During the entire period of treatment, it is extremely important to avoid smoking, drinking alcohol, and try to avoid stress and high physical or mental stress. A gentle diet correctly selected by a doctor is also important.

Clinical picture

To prevent the development of the disease, you need to know its initial signs. Symptoms of sensorineural hearing loss can vary depending on the individual. The onset of the pathological process is always accompanied by decreased hearing and the appearance of various noises in the ears (for example, whistling or ringing). The rest of the clinical picture depends on the form of the disease. There are four of them: sudden, acute, progressive and chronic.

The first is considered the most favorable. It develops within 24 hours due to an infectious disease of viral or bacterial etiology. Against the background of complete health, an immediate decrease in hearing is observed.

Acute cochlear neuritis develops sequentially and lasts no more than a month. Patients first complain of a feeling of ear fullness, which periodically disappears. Subsequently, hearing loss becomes permanent. The acute version of the disease can become chronic.

The progressive form is characterized by further deterioration of hearing against the background of already existing hearing loss. As a result, the pathology ends in complete deafness. Chronic hearing loss is characterized by a long course. The stages of intense attacks gradually give way to stages of remission. Over time, periods of exacerbation become longer and longer.

Sometimes the clinical picture is supplemented by vestibular disorders. These include loss of balance and nausea, dizziness. These symptoms usually worsen when turning the head or sudden changes in body position.

Depending on the location of the pathology, it can be unilateral or bilateral. In the first case, the symptoms of the disease appear only in one ear, and in the second - in both at the same time. The intensity of the lesion may vary. With bilateral sensorineural hearing loss, the emotional coloring of the patient’s speech disappears. Such people are unsociable and socially disoriented.

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;
• maternal drug use;
• 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.

Causes of hearing loss

In newborns, the cause of hearing loss is most often pathological pregnancy. Infectious diseases suffered by the mother, taking ototoxic drugs, and fetal hypoxia affect the formation of hearing.

In preschool children, symptoms of hearing loss appear after suffering from otitis media, inflammation of the maxillary cavity, and nasopharynx. Remaining unrecognized in the acute period, hearing loss becomes chronic in adulthood.

Acute hearing loss in adults occurs as a result of taking medications that negatively affect the ability to hear. The list of ototoxic drugs that cause permanent hearing loss is constantly growing. Pathological changes in the inner ear cause vascular disorders, ear injuries, brain tumors, vibration, noise.

Classification of deafness and hearing loss

In medicine, types of pathologies are classified according to the level of their damage, the reasons for their occurrence and depending on the nature of the course.

Classification by level of damage

Decreased hearing quality occurs as a result of damage to one or two hearing organs. Depending on which part of the organ is affected, hearing loss is classified as sensorineural, conductive and mixed.

Sensorineural hearing loss is characterized by damage to the part of the analyzer that is responsible for the perception of sounds. They reach and are perceived, but the brain does not recognize them. This situation can arise as a complication of Meniere's disease. In this case, increased pressure in the inner ear is diagnosed. It also appears due to measles or meningitis, and some viral diseases.

Sensorineural hearing loss can be either congenital or acquired. Develops after taking antibiotics, diuretics and anti-inflammatory drugs, exposure to too loud sounds and injury.

Conductive hearing loss occurs as a result of problems in the outer and middle ear, which are responsible for receiving and transmitting sounds to the brain. The causes of the disease are sulfur plugs, inflammation and injury. Conductive pathology is an acquired disease. Mixed hearing loss combines the symptoms of the first two types and affects the inner ear.

Classification by reasons of development

Depending on what factors caused the appearance of hearing loss, the following types are distinguished:

• congenital (hereditary or perinatal);
• acquired.

Hereditary hearing loss is the result of a decrease in the quality of hearing in children, but the first signs of pathology can only become apparent in adulthood. The disease is caused by mutations in the genetic material of one of the parents.

Perinatal occurs due to disturbances in the development of the fetus in utero or during a problematic pregnancy. These include:

• injuries received during childbirth: entanglement, damage to the skull bones;
• infectious diseases at different stages of pregnancy;
• chronic diseases in a pregnant woman;
• direct and indirect poisoning of the expectant mother’s body (smoking, alcohol, living in an area with a poor environment, working with chemicals).

The acquired disease develops gradually under the influence of provoking factors:

• diseases of the auditory nerve or ENT organs;
• head injuries;
• taking medications;
• viral infections;
• prolonged exposure to high decibels.

Acquired hearing loss can be either sensorineural or conductive.

Classification according to the nature of the pathology

Depending on the influencing factors, the disease can develop literally in a month, and in another case, symptoms will appear gradually, with a possible exacerbation of symptoms. Based on this, sudden deafness, acute and chronic hearing loss are distinguished.

Sudden deafness is a complication after infectious diseases. This occurs due to disturbances in cerebral circulation, tumor processes or medication. In such cases, unilateral or bilateral deafness develops instantly and hearing can be restored just as quickly.

The acute form of the disease is characterized by hearing loss within a few days. First, temporary hearing loss and ear congestion appear, which progress over time. There are four types of acute hearing loss:

• vascular - occurs as a result of disorders in the brain and ears. The reasons for this may be diabetes, osteochondrosis and other diseases;
• viral - caused by viral infections, which provoked inflammation;
• toxic - a complication from medications, poisoning with toxic substances;
• traumatic - the result of injuries and bruises to the head and ears.

Chronic hearing loss develops from several months to several years. Constant tinnitus greatly interferes with a person’s ability to fully listen and communicate. The disease varies from a progressive stage to a quiescent stage. In the first case, continuous hearing loss occurs. At the stable stage, no decrease is observed. This period lasts approximately six months.

The first step to making a diagnosis is to visit a doctor.