[Endothelial dysfunction as a pathogenetic factor of sensorineural hearing loss]

Chronic sensorineural hearing loss (SNHL) is a common disease that leads to disability of the population. Despite the many reports devoted to SNHL, the question of the pathogenesis of the disease is still open. Many researchers consider the development of SNHL as a manifestation of microangiopathy. The mechanism of development of microangiopathy in SNHL is multifactorial, but most researchers agree that endothelial dysfunction (ED) triggers a complex of pathological changes in the vessels of the inner ear.

OBJECTIVE

Review of the results of scientific research in recent years on the problem of etiopathogenesis of sensorineural hearing loss from the perspective of endothelial dysfunction in the formation of auditory disorders.

[Characteristics of neurosensory hypoacusis and perspectives of its differential diagnosis basing on registration of evoked otoacoustic emission]

The examination of 135 patients with neurosensory hypoacusis and 97 otologically healthy persons has determined parameters of delayed otoacoustic emission and otoacoustic emission at the frequency of the distortion product for etiologically different forms of neurosensory hypoacusis. These parameters allowed selection of statistically significant homogeneous groups. Basing on a total of parameters of evoked otoacoustic emission in each homogeneous group and affiliation of an individual patient to one of the above groups one can identify genesis of neurosensory hypoacusis.

[Specific features of otorhinolaryngologic diseases in patients with hemophilia]

The fact that ENT doctors infrequently diagnose hemophilia is explained by their inadequate knowledge of the disease. We examined 35 patients suffering from hemophilia A and 3 patients suffering from hemophilia B. The most frequent ENT pathology in them was relapsing nasal hemorrhages of varying intensity and duration (20 patients). Chronic tonsillitis was identified in 17 hemophiliacs. In 2 patients, angina was aggravated by hemorrhages from the tonsils and life-threatening hemorrhages to the soft tissues of the pharynx, neck and mediastinum which led to airways stenosis. In 3 patients, adenoids of the I degree and in 5 patients, adenoids of the II degree were detected. Among other ENT pathologies mention should be made of deformed nasal septum (13 cases), chronic otitis media (4 cases) and chronic suppurative mesotympanitis (1 case). In summary, the most common ENT disease in hemophiliacs is pathology of the lymphadenoid pharyngeal ring detected in more than half of the patients examined. Taking into consideration the specific and life-threatening pattern of potential complications of this pathology, it is important to choose efficient therapeutic methods.