Analysis of etiopathogenetic factors in the development and progression of perceptual hearing loss

Abstract

Relevance: Sensorineural deafness is a polyetiological disease. The most studied etiopathogenesis factors are vascular, acoustic and age. Despite numerous studies, the factors of the development and progression of chronic sensorineural hearing loss, as well as tinnitus, remains unclear in 25-30% of cases. Purpose: to determine the most influential factors in the development and progression of sensorineural hearing loss in patients who work in conditions of increased sound load. Methods and materials: The study was conducted on the basis of the Kyiv Clinical Hospital on Railway Transport No. 2, as a division of the Department of Otolaryngology of the O.O. Bogomolets National Medical University. We conducted an examination of 678 patients who work under conditions of increased acoustic load (drivers, drivers' assistants, fitters, railway track fitters) with the aim of identifying perceptual disorders and analyzing the etiopathogenesis factors of chronic sensorineural hearing loss. Further examinations were carried out in 89 patients who had perceptual disorders. Results: The first degree of deafness was detected in 75.3% of patients, the second and third - in 12.35% each. The largest number was made up of patients aged 56 to 65 years, but even among those examined up to 45 years of age, there were 2 cases of third-degree hearing loss. The correlation between age and the degree of deafness in patients with perceptual disorders, as well as age and decreased whisper perception was weakly positive: 0.167 and 0.261, respectively; The relationship between indicators of work experience and the degree of hearing loss, as well as work experience and a decrease in the perception of whispered speech – the average degree of severity is 0.382 and 0.476, respectively. These data were confirmed with the help of two-factor analysis. Conclusions: Among patients with perceptual disorders who work in conditions of increased sound load, the largest number was aged 56-65 with more than 30 years of experience and had the first degree of hearing loss. The relationship between hearing impairment and age and work experience was found to be weak and medium, respectively. 11.1% of cases of third-degree hearing loss were found among patients under 45 years of age and with a work experience of up to 30 years. This may indicate the presence of other factors in them, for example, genetic disorders, which significantly affect the development and progression of sensorineural hearing loss and require further research.