PRINCIPLES OF TREATMENT OF ELDERLY PATIENTS WITH COMPLICATIONS OF SENSORINE HEARING LOSS

Аннотация

One of the urgent problems of modern otolaryngology is the treatment of patients with sensorineural hearing loss. This is explained by the social significance of this pathology. The solution to the problem of sensorineural hearing loss is closely related to the success of treatment and prevention of vascular diseases. High sensitivity of the cells of the spiral organ to oxygen deficiency leads to the fact that circulatory disorders in the inner ear can affect hearing acuity. We examined 60 people aged 55 to 70 years, all patients were consulted by a therapist and a neurologist. The analysis data allowed us to establish that in patients with sensorineural hearing loss after complex treatment there is a decrease in the tone of small and medium-sized vessels in the internal carotid artery basin, a decrease in CA and an improvement in blood filling in both basins, however, not all the identified changes in the indicators were dynamic. Keywords. Presbycusis, atherosclerosis, anacorta, rheoencephalogram. Age-related changes in auditory function in atherosclerosis are based on morphological changes in the inner ear, in particular, in the spiral organ and vascular strip; morphological studies have established that the vascular system of the cochlea undergoes age-related changes [5,9,12]. They concern the caliber of arterioles and venules, a reduction in their number, and the disappearance of some arteriovenous anastomoses. [1,3,5] In vascular atherosclerosis, the main curl of the cochlea is selectively affected (degenerative process). However, in general, the problem of inner ear pathology occurring against the background of vascular atherosclerosis has not been sufficiently studied. [2,4,6] In this regard, it is advisable to further study the state of cerebral circulation for the diagnosis and treatment of elderly patients suffering from sensorineural hearing loss [7,8,11]. It has been established that atherosclerosis of the cerebral vessels causes damage to the auditory system at the level of the main cochlear curl, which is supplied with blood mainly by the vertebral and basilar arteries [1,7,13]. The most unfavorable is the combination of atherosclerosis and hypertension, which leads to secondary microcirculation disorders in the 378 Yanvar, 2025-Yil vascular strip and can be one of the common causes of sensorineural hearing loss in patients regardless of age [3,9,11]. The aim of the studyThe aim was to identify treatment tactics for sensorineural hearing loss in the elderly. Materials and methods of research. To achieve the set goal, we examined 60 people aged 55 to 70 years, among them there were 32 women, men - 24 people aged 55 to 60 years and 36 people aged 60 to 70 years. In 16 people, hearing loss began 10 years ago, and in 44 - over 10 years. All patients were consulted by a therapist and a neurologist. No pathological abnormalities were found in the blood (general analysis and for sugar) and urine. X-ray examination revealed phenomena of osteochondrosis of the spine in the region of the IV-VI cervical vertebrae in all patients. 12 people had a periodic increase in blood pressure, people with hypertension are not included in the development. The most frequent complaints of the examined were hearing loss and tinnitus, which is permanent in 37 patients. Pathological intentions on the part of other ENT organs were not revealed. Research results. Hearing was examined before and after treatment: the perception of whispered and spoken speech was determined, threshold and suprathreshold, and tonal speech audiometry were performed. 15 people perceived whispered speech at a distance of up to 1 m, 16 from 1 to 3 m, 8 more than 3 m, and 21 did not hear it. Spoken speech at the auricle was heard by 6 patients, at a distance of 0.1 to 1 m - 14, from 1 to 3 m - 10, from 3 to 5 m - 17, and more than 5 m - 13. The degree of hearing loss by air conduction in two frequency ranges (speech and upper) is presented in Table 1. Table 1. Perception of tones by air and bone conduction in elderly patients with sensorineural hearing loss before treatment. Studied Auditory perception thresholds in patients before treatment indicators Up to 30 dB 31-50 dB 51-70 dB more than 70 dB 125- 4000- 125- 4000- 125- 4000- 125- 4000- 3000 8000 3000 8000 3000 8000 3000 8000 Hz Hz Hz Hz Hz Hz Hz Hz 379 Yanvar, 2025-Yil Air 19 11 14 14 13 16 14 19 conductivity Bone 18 9 13 16 14 18 15 17 conduction Table 1 shows that hearing loss of more than 50 dB at frequencies of 125-3000 Hz was observed in 27 individuals, in the range of 4000-8000 Hz – in 33 individuals. The state of cerebral circulation was assessed based on rheoencephalography data; rheoencephalograms were recorded using a six-channel 6-NEK (GDR) electrocardiograph and an RG-1M rheographic attachment using the generally accepted technique for the frontomastoid (F-M) and occipito-mastoid (O-M) leads, characterizing the state of the internal carotid and vertebral artery basins. When evaluati