[Sudden hearing loss--our experience in treatment with vasoactive therapy].

INTRODUCTION: A specific title "sudden hearing loss" refers to illness which is characterized by a sudden, rapid sensoneural hearing loss mostly in one ear without obvious causes, accompanied with dizziness, and without vestibular symptomatology. It is defined as a hearing loss for more than 30 dB on 3 or more successive frequencies which appear in 72 hours. OBJECTIVE: The main goal of our paper was to estimate success of implementation of vasoactive method in patients with sudden hearing loss of senso-neural type in different ranges in hospital conditions. METHOD: Our research covered 37 patients hospitalized because of a sudden hearing loss of sensoneural type in different ranges. Diagnosis, in all patients, was established by clinical ORL examination, audiology and vestibular examination. R including CT and MR, neurological, internist and laboratory examinations were used in order to exclude other aetiology. In monitored patients, we started treatment with vasoactive therapy, ampules of xanthinol nicotinate (one ampule of 2 ml, 300 mg) or ampules of pentoxiphylline (one ampule of 5 ml, 100 mg) in form of infusions with addition of vitamins with an everyday gradual increase of dosage up to 12 ampules of xanthinol nicotinate and up to 5 ampules of pentoxiphylline. Then we started with an everyday decrease of dosage down to the first one. RESULTS: After the complete curing protocol, we found out that in patients with light and medium senso-neural damages of hearing sense (23 or 62%), hearing recovery was complete. In patients with heavy damage of hearing (9 or 24%), partial success was evidenced. The most difficult cases, with complete hearing loss, heavy buzzing and vertiginous problem (5 or 14%) responded to therapy, so buzzing and vertiginous problems disappeared but hearing was not improved. CONCLUSION: Usage of vasoactive medicaments in hospital conditions in treatment of sudden hearing loss gives good results and it is the closest to aetiological therapy.

[Effect of noise on changes in the acoustic reflex]. / Promene parmetara akustickog refleksa pod dejstvom buke.

Acoustic, stapedial reflex represents a response of the m. stapedius to a sonic excitation of supra speech intensity. It is the constitutive part of impendancmetric investigations, it is performed on the same apparatus after tympanometry, and it is the inseparable part in representation of impendancmetric findings. Until now, the most frequently monitored parameters of acoustic reflex of clinical importance are: threshold, amplitude, output and input angle of the reflex curve. The aim of this work was to performed detailed analysis of mentioned parameters in workers exposed to extensive action of industrial noise of known physical characteristics (of different durations) and to establish which changes occurred in these workers, to what extent and under which conditions. Investigations included 173 industrial workers (346 ears), which work in working unit "Forge", where during the working process noise is produced which is above permissible limits and of the unfavorable frequency content. Workers were divided into two groups. The first group consisted of workers who were spending the whole working time in the workroom with noise above permissible limits, the second group consisted of workers who were spending 3 hours of the working time in that workroom, while the control group consisted of workers who were spending the whole working time in that workroom but they did not have any hearing impairment. Workers of the first and the second group had the hearing impairment, which occurred exclusively as a consequence of chronical acoustic trauma. For all the workers the anamnesis was taken, as well as ORL status and audiometric and impendancmetric investigations were performed, namely the tympanometry and acoustic reflex. Results have shown that the acoustic reflex threshold at 500 Hz and at 1000 Hz for the first group (95.10 dB) was increased with respect to the reflex threshold of the second and the control group (84 dB). At higher frequencies of 2000 Hz and 4000 Hz an increase of the reflex threshold was found for the first and the second group (96 dB) with respect to the control group (87 dB). The amplitude of acoustic reflex was increased, at frequencies 500 Hz and 1000 Hz (3.38), with respect to the second group (2.78) and the control group (2.36), and at higher frequencies, this increase is more prominent. The input angle of the reflex curve was, for the first and the second group, within limits 41 degrees to 50 degrees, and for the control group was from 31 degrees to 50 degrees. The output angle was, at majority of ears of the first and the second group, from 26 degrees to 35 degrees, and for the control group it was from 16 degrees to 35 degrees. Acoustic reflex, as the noninvasive method, short term one, objective and simple for application, does not require collaboration of workers, what provides for objectivity of obtained results and what caused that wrongful estimations, impressions and subjective reactions of workers were avoided.