Acoustic trauma to the hearing organs - symptoms and treatment. The concept of ear contusion: causes and treatment of pathology Treatment of acoustic trauma of the ear with folk remedies

Ear contusion refers to the category of acoustic injuries that occur when there is a sudden change in pressure in the hearing organs. As a result, a change in the anatomical features of the ear is observed. Quite often, due to exposure to unfavorable factors, there is a rupture of the eardrum, as well as a decrease in hearing function.

Mechanism of development and manifestation

Ear injury in most cases occurs when the eardrums are exposed to excessively loud sounds. There are a significant number of factors due to which the pathological process develops. The occurrence of the disease can be diagnosed after:

• shots;
• loud music;
• explosions;
• loud scream, etc.

The occurrence of pathology can be observed when the sound increases to more than 160 dB. This is why the disease can be diagnosed after setting off fireworks or even a loud kiss on the ear. This can stretch or damage your eardrums.

The appearance of a contusion is accompanied by a sharp and oppressive pain in the middle of the ear. The pain can go away on its own in the shortest possible time. Some people experience pain for a long period of time. If deafness or bleeding from the ear occurs after exposure to loud sounds, then you need to seek help from a specialist who can provide adequate first aid.

Regardless of the severity of the disease, the patient experiences the appearance of corresponding symptoms during concussion:

1. The pathology is accompanied by severe pain in the ear.
2. Also, after a contusion, the appearance of hearing loss or complete deafness is observed.
3. The pathological process in some patients is accompanied by disorientation.
4. A fairly common symptom of contusion is ringing in the ears.
5. After damage to the auricle, dizziness may be diagnosed.
6. When exposed to significant amounts of sound, people experience bleeding from the ear or nasal cavity.
7. When this pathological process occurs, vision may be impaired.
8. In rare cases, patients experience loss of consciousness.

Contusion is a fairly serious pathological process, therefore, when the first signs appear, the patient should consult a doctor, who, after diagnosis, will prescribe treatment aimed at restoring hearing.

Features of therapy

In case of an ear contusion, the patient must be given first aid, which will have a positive effect on the process of further treatment.

First aid

The person who is nearby must perform coordinated and prompt actions:

The victim must be taken to a medical center, where the patient is examined to determine the severity of the injuries. Diagnosis of pathology requires collecting anamnesis and examining the sore ear. To exclude an infectious process, the patient is recommended to undergo a general blood test and an examination of an ear smear. Other procedures may also be used, such as a CT scan or X-ray if the injury is severe.

First aid must be provided to the patient. Otherwise, complications may occur in the form of significant hearing loss.

Also, after a contusion, the development of various forms of otitis may be observed. If pathology therapy is carried out incorrectly, this can also cause improper functioning of the nervous system.

Further treatment

Treatment of contusion is carried out using medications. Most often, patients are prescribed stimulants and tonic drugs - Hoffmann drops, Camphor. If a person develops vasomotor labyrinthopathy, treatment is carried out with Aeron or Aneurin.

Treatment of the pathological process should be aimed at preventing the development of infection. For this purpose, bacteriostatic agents are prescribed. Treatment with Penicillin or Bicillin is quite effective in this case. If the victim has severe pain, then the use of Morphine is recommended to eliminate it.

If there is a mechanical injury or barotrauma, a protective bandage must be applied to the ear. Injecting liquid into the hearing organ is strictly prohibited. For severe damage to the eardrum, surgery may be recommended.

If a patient is diagnosed with increased excitability or insomnia, then he needs to take sedative medications (Sedafiton, Nervohel). During the period of treatment of contusion and recovery, the patient must be provided with complete rest. It is recommended to protect his hearing organs from the negative influence of loud sounds.

Contusion is a rather dangerous pathological process. If first aid is provided incorrectly and the patient is treated inadequately, serious complications can develop. That is why, after receiving an injury, the patient needs to undergo appropriate diagnostic measures, which will make it possible to prescribe adequate treatment.

Occurs with short-term or long-term exposure to strong sounds (more than 120 dB) on the hearing organ. There are acute and chronic acoustic trauma. Acute injury is a consequence of short-term exposure to extremely strong and high-pitched sounds (for example, a loud whistle in the ear, etc.). The intensity of these sounds can be so great that the sensation of the sound is usually accompanied by pain. Histological examination of the cochlea of ​​animals subjected to experimental acoustic trauma reveals hemorrhage in the cochlea, displacement and swelling of the cells of the spiral organ.

In everyday life, chronic acoustic noise injury is more common, the occurrence of which is based on the factor of fatigue during prolonged exposure to intense sounds on the hearing organ. Hearing damage caused by exposure to short-term noise is often reversible. On the contrary, prolonged and repeated exposure to sound can even lead to atrophy of the organ of Corti. The severity of hearing damage increases sharply with simultaneous and prolonged exposure to noise and vibration (for example, weaving shops, blacksmithing, etc.).

Diagnostics based on medical history, general examination of the patient and the results of a hearing test. Usually, with acoustic trauma, treble hearing loss and increased thresholds for the perception of sounds in the bone are observed. Treatment. In the initial stages of the development of occupational hearing loss, it is necessary to resolve the issue of changing profession. Persons working in noisy industries must use personal protective measures against industrial noise.

Treatment in case of already developed occupational hearing loss, it involves carrying out the same measures as for sensorineural hearing loss. General strengthening therapy, sedatives, vitamin therapy (B vitamins, C, A and E), and a rational work and rest regime are prescribed.

Prevention professional hearing loss is carried out by a complex of medical and technical measures. It comes to the fore to conduct a thorough professional selection process when enrolling in jobs that involve high levels of noise in production. Special tests are used to assess the degree of fatigue of the auditory analyzer when exposed to strong sounds. If the restoration of normal hearing acuity takes an excessively long time, then such candidates are considered less resistant to noise exposure. Periodic hearing tests of workers are important. Technical methods involve reducing the intensity of sound in production by implementing measures aimed at sound absorption and sound insulation. The volume of low-frequency sounds should not exceed 90-100 dB, mid-frequency - 85-90 dB, high-frequency - 75-85 dB. Personal protective equipment involves the use of anti-noise devices of various designs.

Vibration injury (vibrotrauma), as the name itself shows, occurs as a result of vibration vibrations (shocks) produced by various mechanisms (tools, vehicles). Studying the results of vibration exposure in an experiment on animals made it possible to detect degenerative changes in the cochlea (in the apical helix and spiral ganglion cells), as well as in the auditory and vestibular nuclei. The nature of these changes corresponds to the strength of vibration and the duration of its impact.

Treatment is carried out similarly to that for acoustic trauma, given their close anatomical relationship. It should only be added that in order to prevent vibration injuries, measures for vibration isolation, vibration damping and vibration absorption are also carried out.

Barotrauma occurs when there is a sudden change in atmospheric pressure. The middle and inner ears are most sensitive to this change. There are two types of barotrauma. In the first case, injury develops when pressure changes only in the external auditory canal, for example, a blow to the ear with a palm when using a pneumatic Siegl funnel. The cause of the second type of barotrauma is the difference in pressure in the environment and the tympanic cavity, for example, when flying in an airplane, diving among divers, caisson workers, etc. A combination of baro- and acoustic trauma occurs during explosions and shots at close range. Such disorders are based on an instantaneous increase in atmospheric pressure and the sudden impact of high-intensity sound, which causes contusion of the ear and brain organs of varying severity.

The otoscopic picture during barotrauma is characterized by the appearance of hyperemia of the tympanic membrane with hemorrhages in its thickness. Sometimes there are ruptures or complete destruction of the eardrum. In the first 2 days after injury, inflammatory changes may not be detected, then inflammation becomes more noticeable. When there is hemorrhage into the tympanic cavity while the membrane is intact, it acquires a dark blue color.

Barotrauma is also accompanied by a number of functional disorders of the inner ear and central nervous system. The patient develops noise and ringing in the ears, decreased hearing, dizziness, and nausea. Sometimes there is loss of consciousness.

The degree of hearing loss due to barotrauma varies depending on which part of the auditory analyzer the changes occur. In childhood, barotrauma sometimes develops during an airplane flight if the patency of the auditory tubes is impaired due to hypertrophy of the pharyngeal tonsil or peritubular ridge.

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Inner ear damage

Barotrauma. Barotrauma of the hearing organ as a result of an increase or decrease in atmospheric pressure can occur while flying in an airplane, when working under water and diving to great depths.

Barotrauma of the eardrum and cavity can occur either with a rapid increase in pressure (even by one third) on the eardrum through the external auditory canal, or vice versa, with a rapid rarefaction of air in the ear canal, as well as with an increase in pressure from the side of the eardrum (forced blowing of the eardrum). pipes, energetic nose blowing, sneezing).

When there are changes in atmospheric pressure, injury can occur only if it changes quickly, especially if the auditory tube is poorly patted. Depending on the intensity of pressure changes, certain damage to the eardrum, middle or inner ear occurs (the latter is especially common when barotrauma is combined with concussion and acoustic trauma).

Aerootite (barootite). Symptoms of the disease with a persistent comparative increase in pressure in the external auditory canal and nasopharynx are congestion, ear pain, noise with decreased hearing, and sometimes mild dizziness. During otoscopy, depending on the severity of the barotrauma, retraction of the tympanic membrane, injection of its vessels, hyperemia, thickening, hemorrhage and rupture of the membrane are detected. Serous effusion or hemorrhage (hematotympanum) may be observed in the tympanic cavity.

Treatment. Vasoconstrictor drops in the nose, thermal procedures on the ear, analgesics are prescribed, and immediately after the flight the auditory tube is blown (Valsalva experiment, Politzer blow). If effusion or hemorrhage is detected in the tympanic cavity, tympanopuncture with aspiration of fluid or paracentesis with the introduction of corticosteroids and proteolytic enzymes into the tympanic cavity should be performed. If infection develops, the same treatment is given as for acute otitis media.

Barotrauma when working in a caisson. The increase in pressure during airlock corresponds to compression in the aircraft during a rapid descent, and when leaving the airlock, it corresponds to the ascent of the aircraft. Equalization of changing atmospheric pressure and pressure in the tympanic cavity during sluicing and exiting the sluice is ensured by the normal patency of the auditory tube. With a rapid increase in pressure during sluicing, a clinical picture develops similar to that of aerootitis - barotrauma of the middle ear. In this case, the danger is posed by rapid decompression - a drop in elevated atmospheric pressure (with an unacceptably fast exit from the caisson, there is a threat of gas embolism).

Decompression sickness refers to indirect damage to the inner ear. Due to prolonged (7-10 hours) exposure to high pressure, an excess amount of nitrogen accumulates in the tissues of the body, and up to 80% of poorly soluble nitrogen enters the blood. If the pressure drops too quickly (when leaving the caisson), such an amount of nitrogen does not have time to be released with the exhaled air.

Nitrogen bubbles circulating in the blood can clog the vessels of vital organs, as well as the vessels of the inner ear. In addition to gas embolism of the labyrinthine vessels, rapid decompression causes a sharp increase in blood pressure and hemorrhage into the labyrinth. In case of severe damage, damage to the sensitive epithelium of the inner ear is possible, the symptoms of which are noise in the ear that appears several hours after leaving the caisson, hearing loss, dizziness, and vomiting. Depending on the severity of the lesion, these symptoms last from several days to several weeks.

More often they are reversible, but if the sensitive epithelium is damaged, hearing loss and, as a consequence, persistent deafness or loss of vestibular function remain.

Treatment. In case of barotrauma in a caisson, the patient is immediately placed in the caisson and very slowly removed from it. It is advisable to replace nitrogen in the air with helium that is easily soluble in the blood, as a result of which the danger of gas embolism is reduced. With intense noise in the ear, infusions of lidocaine (1 ml of 4% solution) and corticosteroids into the tympanic cavity have a good effect. The mechanism of loss of cochleovestibular function is the rupture of the round window membrane.

In this case, conservative treatment is carried out and only if there is no effect - surgical treatment: the defect is closed with a fascial or fatty implant.

Ear barotrauma in divers and divers is similar in origin, although they experience less significant damage. However, at a depth of 4-6 m, perforation of the eardrum may occur. Water penetrating the tympanic cavity, in turn, causes a cold reaction with dizziness and disorientation under water. When quickly rising from great depths, nitrogen embolism in the inner ear, vascular spasm, sudden hearing loss, tinnitus, and dizziness may occur.

Acute acoustic trauma. Acute acoustic trauma refers to hearing damage caused by a single short-term exposure to strong sound. During detonation (shot or explosion) at close range, a combination of mechanical trauma to the ear by an air wave (tympanic membrane, structures of the middle ear, membranes of the inner ear) due to a sudden increase in atmospheric pressure with acoustic trauma is noted. The shot is characterized by high sound pressure peaks (150-180 dB), short pulses (2 ms), and high-frequency components. An explosion is characterized by the combined effect of high sound pressure and a strong push of an air wave.

Acute acoustic trauma can also occur as a result of exposure to sharp high-pitched (for example, the whistle of a steam locomotive) or extremely intense (the noise of jet engines, reaching 150-160D6) sounds.

Damage to the inner ear does not depend on the severity of damage to the eardrum and middle ear. With an intact eardrum, all sound energy is conducted into the inner ear; with the most significant damage to the eardrum and middle ear, they, on the contrary, play the role of a safety valve and the inner ear may remain intact. When struck by a blast wave, both the middle and inner ears are affected, resulting in mixed hearing loss.

When the inner ear is damaged, hearing loss of the perceptive type occurs, characterized by a decrease in hearing for high tones - in the 4 KHz region or for all high tones, the occurrence of the phenomenon of accelerated increase in volume (AFG) and tinnitus. Hearing loss is often bilateral, asymmetrical, sometimes progressive, accompanied by ear noise, often ringing.

Treatment. It is carried out according to the same principle as for sudden hearing loss. It includes intravenous injections of low molecular weight dextran, antihypertensive drugs, blockade of the stellate ganglion, etc. If the eardrum and auditory ossicles are damaged, appropriate treatment is subsequently carried out (myringo-, tympanoplasty).

Electrical ear injuries

There are primary ear injuries (direct or indirect) and secondary manifestations. Direct damage is a high-temperature injury (burn). Perichondritis with cartilage necrosis, injury to the eardrum up to rupture and the middle ear are possible, direct damage to the inner ear (hearing loss, deafness), irritation or loss of vestibular function may occur.

Cochleovestibular disorders can occur due to damage to the auditory nerve of the retrolabyrinthine and central areas, and paresis of the facial nerve is possible. Electrothermal injuries can lead to irreversible hearing damage.

Indirect primary damage to the ear occurs regardless of where the current enters (lightning strike or exposure to the current during operation with a high-voltage installation).

The resulting general muscle cramps, increased pressure in the body cavities with increased blood pressure in the cerebrospinal fluid cause tinnitus, hearing loss, and dizziness. In addition, a fall can cause trauma to the skull, resulting in the development of vestibular disorders.

Treatment. Intensive therapy is carried out: anti-shock and anti-burn measures, anti-inflammatory general and local therapy, corresponding to the treatment of injuries to the middle and inner ear.

IN. Kalina, F.I. Chumakov

Arises from short-term or long-term exposure to low-pitched sounds (more than 120 dB) on the organ of hearing. Acute and chronic acoustic trauma are distinguished. Acute trauma is a consequence of short-term exposure to extremely strong and high-pitched sounds (for example, a loud whistle in the ear, etc.).

The intensity of these sounds can be so great that the sensation of sound is usually accompanied by Rot. Histological examination of the cochlea of ​​animals subjected to acoustic trauma reveals hemorrhage in the cochlea, displacement and swelling of the cells of the spiral organ.

In everyday life, chronic acoustic noise injury is more common, the occurrence of which is based on the factor of fatigue due to prolonged exposure to intense sounds on the hearing organ. Hearing impairment caused by exposure to short-term noise is often reversible. On the contrary, prolonged and repeated exposure to sound can even lead to atrophy of the organ of Cortiea. The severity of hearing damage increases sharply with simultaneous and prolonged exposure to noise and vibration (for example, weaving workshops, blacksmithing, etc.).

Diagnosis is based on anamnesis, the patient’s general history and the results of a hearing test. Usually with lk\e tpch

Treatment In the initial stages of the formation of a professional career, it is necessary to resolve the issue of changing profession. Persons working in noisy industries must use specific measures to protect themselves from industrial noise. Treatment for developed occupational hearing loss involves the same measures as for sensorineural hearing loss. General strengthening therapy, sedatives, vitamin therapy (B vitamins, C, A and E), and a rational work and rest regime are prescribed.

Prevention of occupational hearing loss is carried out through a complex of medical and technical measures. It comes to the fore to conduct a thorough professional selection process when enrolling in jobs that involve high levels of noise in production. Special tests are used to assess the degree of fatigue of the auditory analyzer when exposed to strong sounds. If the restoration of normal hearing acuity in summer takes an excessively long time, then such candidates will experience Vibration trauma (vibrotrauma), as the name itself shows, occurs as a result of vibration vibrations (shocks) produced by various mechanisms (tools, vehicles). Studying the results of vibration exposure in an experiment on animals made it possible to detect degenerative changes in the cochlea (in the apical helix and spiral ganglion cells), as well as in the auditory and vestibular nuclei.

The nature of these changes corresponds to the strength of vibration and the duration of its impact.

Treatment is similar to that for acoustic trauma, given their close anatomical relationship. It should be added that in order to prevent vibration injuries, the following measures are carried out: vibration insulation, vibration damping and vibration damping.

Barotrauma occurs when there is a sudden change in atmospheric conditions. The middle and inner ears are most sensitive to this change. There are two types of barotrauma. In the first case, injury develops when pressure changes only in the external auditory canal, for example, a blow to the ear with a palm when using a pneumatic Siegl funnel. The cause of the second type of barotrauma is the difference in pressure in the environment and the tympanic cavity, for example, when flying in an airplane, diving among divers, caisson workers, etc. A combination of pressure and acoustic trauma occurs during explosions and shots at close range. Such disorders are based on an instantaneous increase in atmospheric pressure and the sudden impact of high-intensity sound, which causes contusion of the ear and brain organs of varying severity.

The otoscopic picture during barotrauma is characterized by the appearance of hyperemia of the tympanic membrane with hemorrhages in its thickness. Sometimes there are ruptures and complete destruction of the eardrum. In the first 2 days after the first injury, inflammatory changes may not be detected, but then inflammation becomes more noticeable. When there is hemorrhage into the tympanic cavity while the membrane is intact, it acquires a dark blue color.

Barotrauma is also accompanied by a number of functional disorders of the inner ear and central nervous system. The patient develops noise and ringing in the ears, decreased hearing, dizziness, and nausea. Sometimes there is loss of consciousness.

The degree of hearing loss due to barotrauma varies depending on which part of the auditory analyzer the changes occur. In childhood, barotrauma sometimes develops during an airplane flight if the patency of the auditory tubes is impaired due to hypertrophy of the pharyngeal tonsil or peritubular ridge.

Treatment. First aid for barotrauma, accompanied by a violation of the integrity of the eardrum, bleeding of the eardrum or hemorrhage into the thickness of the membrane, consists of a thorough but very careful cleaning of the ear canal from clots of debris, possible foreign impurities (an explosion could cause grach.p>) with the help sterile cotton wool, wrapped in a pad. Promyn.shps\chd is strictly prohibited, as this can damage the tympanic cavity. After removing the contents of the ear canal, the skin of the ear canal is carefully washed!

Acoustic trauma is damage to the structures of the inner ear, which occurs due to immediate or regular exposure to intense sounds or noise.

The pathology is fraught with hearing impairment - up to the need for hearing aids (use of a hearing aid). It has become especially relevant in the age of loud music, deafening parties and working in noisy environments.

Total information

Acoustic trauma is a very common phenomenon in the 21st century. The chronic form of this pathology is more often observed, and the acute form is much less common. The disease is the cause of sensorineural hearing loss in 25% of all clinical cases of its occurrence.

The vast majority of people affected by acoustic trauma are the working population in the age category from 30 to 60 years. This is explained by the fact that in the vast majority of cases, acoustic trauma is caused by loud sounds due to the specifics of a particular profession. It has been revealed that those people who most often suffer are those who:

• work in closed premises;
• have various diseases of the upper respiratory tract, middle ear, and auditory tubes (most often chronic).

According to statistics, acoustic trauma accounts for about 60% of all diseases and pathological conditions that develop due to the negative influence of physical factors in a particular workplace. In general, acoustic trauma accounts for about a quarter of absolutely all occupational diseases known to medicine.

Men and women get sick with the same frequency. Children are more sensitive to the strength of sound exposure - they can develop acoustic trauma at a sound threshold that does not have any significance for the adult hearing system.

The incidence in different geographical regions is practically the same - be it developed countries or those with a low level of economic development.

Causes

The immediate cause of acoustic trauma is extremely intense sound or noise. How and how quickly ear damage develops depends, first of all, on such characteristics of sound exposure as:

• character;
• duration.

Based on this, there are two main causes of acoustic traumatic damage to ear structures:

• brief (may last less than a second) extremely loud sound;
• constant sound or noise of high or moderate intensity.

Short-term super-strong sounds are those whose volume (intensity) exceeds 120 dB (decibels). It can be:

note

The resulting acoustic trauma can be combined with barotrauma - physical damage to the structures of the inner ear, which was caused due to the difference in pressure from the external environment and the internal cavities of the ear.

Constant intense noise causes acoustic trauma, often if its intensity is 90 dB or higher. In people with increased tissue sensitivity, as well as those whose inner ear has been compromised by injury, acute or chronic diseases, or tissue pathology, acoustic injury can develop when exposed to sound with an intensity of 60 dB. In the greatest majority of cases, the disease develops in people who, due to their duty, are forced to regularly be in an environment with loud sounds and noises. This:

• heavy engineering workers;
• shipbuilding workers;
• employees involved in the aviation sector;
• metallurgists (especially with experience - those who began their careers in rather unsuitable conditions, with a low level of labor protection);
• textile industry workers;
• builders involved in servicing a pile driver - a construction machine designed to drive a construction pile into the ground;
• teachers and social workers who have worked for many years with numerous noisy children's groups (especially if they include people who like to scream and make noise);
• musicians - especially those who perform musical compositions in the style of rock, metal and their “narrow” varieties;
• sound engineers and editors who have been forced to work with sound through headphones for many years;
• employees who serve animals in zoos or circuses that regularly produce loud screams. For example, there is evidence of chronic exposure to the hearing of employees (and subsequent acoustic trauma) to the sounds produced by noisy monkeys, which these employees have served for many years

and others.

Outside of professional influence, the following categories of people are at risk of acoustic injury due to chronic exposure to loud sounds:

• those who like to attend large concerts - these are mainly performances of rock musicians that take place in closed spaces and from which, moreover, it is impossible to leave prematurely due to large crowds of people;
• those who abuse listening to music or other sounds (for example, when watching movies) on headphones. If such abuse is observed over many years, then the intensity of the sound load may not play a role - even moderately intense sounds can cause acoustic trauma in a person after several years of using headphones.

There are also a number of factors that do not directly lead to acoustic injury, but contribute to its development. This:

• Previously occurring compromise of the hearing aid is various diseases of the inner ear (inflammatory, tumor and other nature) and/or its traumatic damage. Both previously suffered pathologies and those diagnosed at the time of the occurrence of acoustic trauma are important;
• endocrinological disorders - first of all, these are (impaired carbohydrate metabolism associated with a lack of the hormone insulin), (increased production of thyroid hormones), (reduced production of thyroid hormones). These diseases are important in the sense that they worsen chemical processes in tissues and their regeneration - in particular, in the tissues of the inner ear;
• malformations of the structures of the hearing aid;
• poor nutrition - in particular, consuming insufficient amounts of proteins, fats, carbohydrates, vitamins, microelements, which negatively affects the regenerative (restorative) properties of hearing aid tissues damaged due to acoustic trauma.

Development of the disease

Depending on the causative factors, acoustic trauma can develop in two forms:

• acute (with simultaneous exposure to strong sounds on the inner ear);
• chronic (due to prolonged, regular exposure to sounds and noise of increased intensity on the organ of hearing).

Acute and chronic types of acoustic trauma differ not only in causative factors, but also in that they have different development mechanisms.

If an acoustic injury occurs due to a short-term but intense sound, then the following pathological changes develop in the organ of hearing:

• hemorrhage occurs in the perilymph (liquid contents) of the membranous labyrinth of the cochlea - and it is one of the main elements of the inner ear;
• swelling of the hair cells of the organ of Corti - the receptive part of the auditory analyzer;
• due to swelling - displacement of these cells.

The nerve impulse signaling the sounds of the external environment is formed precisely as a result of the movement of the fluid filling the organ of Corti, therefore, when its cells swell and shift, the sound is distorted. Under the influence of a strong sound, the organ of Corti can even be torn away from its attachment site.

The mechanisms of chronic acoustic trauma are not as well studied as acute ones. But there is evidence that regular exposure to loud noises can cause the organ of Corti to degenerate. In addition, the pathology is aggravated, since against the background of regular intense sounds, the subcortical centers of the brain, which are responsible for the perception of sounds from the external environment, suffer - pathological phenomena such as:

• metabolic disorders (metabolism in tissues);
• phenomena of fatigue of individual nervous structures;
• the formation of so-called pathological foci of excitation, which leads to hearing impairment.

Symptoms acoustic ear injury

The development of the clinical picture of acoustic trauma depends on whether it is acute or chronic.

In the acute form of the described pathology, at the moment of occurrence and perception of a strong sound, the following symptoms are observed:

• pronounced acute;
• sudden hearing loss (one- or two-sided - this depends on the circumstances of the occurrence of a strong sound, in particular, on the location of its source in relation to the ears).

The following develops further:

• the ability to perceive sounds from the external environment is lost;
• sounds are heard only in the form of a gradually fading ringing or a characteristic squeak;
• against the background of such sounds, dizziness and pain inside the ear (aching or throbbing) occur.

If, in addition to acoustic trauma, barotrauma occurs, then the described symptoms are joined by:

• bleeding from the external auditory canal, and often from the nose;
• violation of orientation in space.

• light;
• moderate severity;
• heavy.

For acoustic trauma mild degree sound perception is restored to the original level within 5-30 minutes after the impact of sound on the hearing aid.

For acoustic trauma moderate severity During the first 1-2 hours, the victim hears only loud sounds or screams; in severe cases, for 2-3 hours. After this, sound perception resumes, but hearing loss of varying severity develops.

With chronic acoustic trauma, its clinical picture develops in the form of 4 stages:

• stage of initial manifestations;
• clinical pause stage;
• stage of increasing symptoms;
• terminal stage.

Characteristics of the stage of initial manifestations:

• develops after 1-2 days of exposure to noise;
• discomfort and;
• if external factors stop influencing, then the clinic disappears literally a few hours after the so-called acoustic rest - staying in silence;
• after 10-15 days adaptation occurs, the described symptoms gradually regress (develop in the reverse order);
• The stage lasts on average from 1-2 months to 4-6 years.

Characteristics of the clinical pause stage:

• unpleasant subjective sensations are not observed;
• hearing acuity gradually decreases;
• Duration of the stage is 2-7 years.

Characteristics of the stage of increasing symptoms:

• heard in the ears;
• Hearing loss develops quite quickly. Its development is characteristic: first, the perception of sounds at high frequencies deteriorates, then at medium and low frequencies;
• in addition to the described ENT symptoms, general disorders also develop - increased fatigue, irritability, impaired attention, deterioration of appetite and sleep (up to);
• hearing loss is observed at the same stable level even if the person continues to work under the same conditions for the next 5-15 years.

Characteristics of the terminal stage:

• is formed in people who have increased sensitivity to noise after 15-20 years of working with aggravated noise conditions;
• There is tinnitus (often unbearable), as well as a decrease in hearing acuity. It can even reach such a level that the patient cannot perceive spoken language at a distance of more than 2 meters;
• In addition to the described hearing impairments, there is a deterioration in coordination of movements and balance, regular and periodic.

Diagnostics

If the patient has reported exposure to sound and its characteristic consequences, the diagnosis of acoustic trauma is easy to make. Additional instrumental examination methods will help to detail the disorders that have arisen as a result of this pathology. In particular, the following methods are used:

Differential diagnosis

Differential (distinctive) diagnosis of acute acoustic trauma is carried out with sudden onset (acute) sensorineural hearing loss, which can develop as a result of:

• acutely formed cerebrovascular accident.

Differential diagnosis of chronic acoustic trauma is carried out with such pathologies as:

• – non-inflammatory damage to the inner ear, in which the amount of fluid increases in it;
• presbycusis – deterioration in the perception of sounds, which develops due to age-related atrophic changes in the inner ear;
• tumors of the cerebellopontine angle.

Complications

The most common complications of acoustic trauma are:

The last four pathologies are not disorders of the hearing organ, but often accompany acoustic trauma.

It should also be noted that due to acoustic damage to the organ of Corti, a decrease in its resistance to:

• infectious agents;
• intoxication of the body;
• exposure to pharmacological drugs that are ototoxic (initially “poisoning” the hearing organ).

Treatment of acoustic ear injury

Treatment of acoustic trauma is conservative.

The basis for the treatment of acute types of this pathology are the following:

• complete peace - in particular, sound;
• vitamin therapy - especially effective
• calcium preparations.

Note: If the acoustic injury was not too severe, in some patients hearing returns to its original level within a few hours after the injury.

If hearing loss has developed, it is treated in the same way as hearing loss that develops as a result of chronic acoustic trauma.

In the case of chronic acoustic trauma, treatment is effective at the stages of initial manifestations and clinical pause. If treatment is started in a timely manner, it is possible to achieve an improvement in the level of hearing, but in the later stages they fight to prevent hearing loss from progressing. The treatment of chronic acoustic trauma is based on the following:

Prevention

Acoustic injury is prevented by any measures that prevent the impact of intense sound or noise on the hearing organ. Such activities include the following:

• compliance with safety regulations in conditions that are fraught with loud noise;
• work in premises that provide full sound insulation and sound absorption;
• if necessary, work in conditions of loud sounds - use special headphones;
• periodic preventive examinations to record acoustic injury and improve working conditions.

Forecast

The prognosis for acoustic trauma depends on its type, as well as timely detection and treatment.

In the case of acute acoustic trauma of mild severity, hearing acuity is restored almost to the previous level.