Audiological Research Methods in the Diagnosis of Postoperative Cognitive Dysfunction

Abstract

Introduction. faring loss may be a predictor or a kind of catalyst for cognitive disorders. This may indicate that audiological research methods can take their place in the diagnosis of cognitive impairments or in assessing the risk of their occurrence. The aim is to determine the sensitivity and specificity of audiological methods for the diagnosis of postoperative cognitive dysfunction (POCD). Material and methods . The study involved 40 patients (17 women and 23 men) aged 22 to 77 years. All patients underwent planned abdominal surgery or reconstructive operations on the vessels of the lower extremities using different types of anesthesia. Before and after the operation, all patients underwent neuropsychological assessment of their cognitive status and audiological examination (otoscopy, tonal threshold audiometry, speech tests). Results. The hearing thresholds in a tonal audiometry in all young patients were within normal limits. Peripheral hearing loss was detected in 11,8% of middle-aged patients and 81,8% of the elderly. Initial cognitive impairment based on the results of the MoCA test was also most often observed in a group of elderly patients. POCD was diagnosed in 63,6% of elderly patients, 35,3% of middle-aged and 8,3% of young patients. The results of preoperative speech testing revealed pronounced signs of a deficit in central processing of acoustic information in patients of all age groups. In all elderly patients, there were deviations in at least one of the speech tests, and in 63,6% ofpatients — in both tests (dichotic, RuMatrix). The high sensitivity of speech tests to the assessment of the probability of occurrence of POCD was revealed: for the dichotic test, the sensitivity was 85,7%, for the RuMatrix test 78,6%. Conclusions. Speech audiological tests are highly sensitive, which makes it appropriate to use them at the stage of preoperative diagnosis. Identify deviations from the norm in both speech tests at the preoperative stage may indicate a high probability of development of POCD.