NEW ETIOLOGICAL FACTORS OF OCCUPATIONAL HEARING LOSS

Annotation. On the example of railway and air transport, a number of new issues of occupational hearing loss are shown, requiring study and subsequent implementation in practical health care, as new etiological factors in the development of hearing loss. This concerns the factor of labor intensity, which has a potentiating, pathogenetic significance, along with noise, in the development of hearing loss due to the formation of chronic stress, leading to additional ischemia of the vascular stria and damage to the neuroepithelium of the inner ear. There is a need, along with the development of a methodology for assessing the factor of labor intensity for SOUT of workplaces, to determine the criteria for its negative action when used for the examination of the connection between the disease of the organ of hearing and the profession. In the «List of occupational diseases» in clause 2.4.2. indicated diseases associated with exposure to infrasound (IZ), among the manifestations of which, called sensorineural hearing loss bilateral. However, IZ, as well as low-frequency noise (LFN), were not previously considered as significant adverse factors in relation to the hearing organ in mass clinical trials, therefore, there are no expert criteria for the relationship between hearing loss and their impact, which could be applied in practice, which requires accumulation of evidence base for the subsequent substantiation of an independent nosological form of a disease of the organ of hearing, associated with mechanoacoustic exposure.

Sudden sensorineural hearing loss: a case report supporting the immunologic theory

Sudden sensorineural hearing loss (SSNHL) is one of the autoimmune diseases of the inner ear (AIED), which is characterized by a hearing loss of above 30 decibels in at least three contiguous audiometric frequencies over a time course of 72 hours or shorter. Its cause can be found in only 10% to 15% of patients. Histopathologic findings have reported retrograde neuronal degeneration and atrophy of Corti's organ and of the vascular stria. This paper describes a case of a middle-aged female patient undergoing a treatment for hyperthyroidism who developed bilateral SSNHL. The patient was treated with methylprednilisone (1mg/kg/day) for three days with considerable hearing improvement. This treatment was followed by lung and kidney tuberculosis. The immune mechanism of this entity and the possibility of interconnected participation of the antigen type, of an autoimmune disease and of bacterial infection are discussed.