Clinical and diagnostic characteristics of cochleovestibular function in patients of active working age after exposure to stress

Abstract

Topicality: Long-term and pronounced psychoemotional tension leads to negative changes in the human body. Many aspects of cochleovestibular changes caused by psychoemotional stress are not studied enough to date. Aim: to increase the diagnostic efficiency of auditory and vestibular disorders in patients of active working age after exposure to stress. Materials and methods: 95 patients of active working age with dizziness, which manifested under stress, and 10 persons of control group were studied. The following tests were performed to all patients: survey with the questionnaire "Comprehensive stress assessment", pure tone and speech audiometry, measurement with filtered speech discrimination tests, assessment of the auditory adaptation level, impedancemetry, registration of auditory brainstem responses (ABR), computed static posturography, vestibular testing. Results and discussion: All subjects were divided into three groups according to the results of the survey with the questionnaire "Comprehensive stress assessment": Group 1 included 21 patients with moderate stress, Group 2 included 35 persons with severe stress that could not be compensated and Group 3 included 39 persons under severe stress, moreover 10 of them were on the verge of exhaustion of adaptive capacities. 60 (63.2 %) patients had normal hearing. 24 (25.2 %) subjects had statistically significant (P <0.05) hearing impairment in the high frequency zone compared with the control group, a statistically significant difference in hearing impairment was detected in the entire frequency range in 11 (11.6 %) persons. Central auditory processing disorders were detected in more than half of patients (according to various tests – from 29 (30.5 %) to 49 (51.6 %) persons). Central vestibular syndrome of varying severity was diagnosed in all 95 patients. The most pronounced disorders of balance according to posturography have been reported in patients with severe stress with vision deprivation in the position with closed eyes. Conclusions: An integrated approach allowed to identify and select, besides traditional research methods, supplementary diagnostic measures for optimal assessment of cochleovestibular changes in patients of active working age after exposure to stress, to detect cochleovestibular disorders and differential topical diagnostics of disorders of the central or peripheral portions of the auditory and vestibular analyzers. These included psychological testing, a test battery to determine central auditory processing disorders – hearing adaptation with load, filtered speech discrimination tests, registration of ABR, registration of postural balance using the Wii Balance Board platform, vestibular testing.