Acoustic neuritis: symptoms, treatment. Acoustic neuritis – acute and chronic. Causes, symptoms, diagnosis and treatment of acoustic neuritis

Inflammation of the nerve fibers is usually accompanied by painful attacks, loss of sensitivity and fever. The consequences can be different, up to partial or complete loss of innervation (connection with the central nervous system) of the area where the source of damage is located. Such pathological processes include cochlear neuritis, which is a consequence of inflammation in the inner ear. If left unattended, this phenomenon can lead to hearing impairment and even complete deafness. That is why doctors advise paying attention to neuritis auditory nerve symptoms and treatment in this case will be carried out in a timely manner.

Cochlear neuritis can occur directly from birth or at any other age. This pathology is characterized by tinnitus and painful attacks, as well as irreversible consequences, such as hearing loss. It can occur in one ear or in both ears at once. In the case of acute inflammation auricular nerve the process ends in deafness in 2-3 days.

Damage to the auditory nerve occurs due to many factors, and the main ones are:

Dystrophic disorders located in the articular cartilages of the cervical spine;
Malfunctions cardiovascular system;
Serious head injuries, especially localized in the temporal region;
Neoplasm in the auditory nerve bundle;
Allergic reactions;
Deposits of atheromatous plaques in blood vessels (atherosclerosis);
Disruptions in the endocrine system;
Hemorrhage occurring in the inner ear;
A complication after an infection, such as meningitis, shingles, or typhus;
Otitis of acute, chronic and purulent nature;
Pathological growth of bone in the middle ear, which arose against the background of disruptions in the ear circulatory system;
Flu, ARVI;
Atrophic changes that have occurred in the nervous tissue due to a long course of taking medications (antibiotics, diuretics, etc.) that contribute to the development of intoxication in the ear apparatus.

Cochlear neuritis occurs due to many reasons, but most often appears due to previous or complicated infectious diseases that are prone to an inflammatory process. In addition to the factors mentioned above, less common ones should be noted:

Tendency to bad habits (smoking, alcoholism);
Constantly being in a noisy environment;
Work involving prolonged sensation of vibration.

Symptoms

When the auditory nerve is damaged, people are most often tormented by constant noise or ringing in the background. general deterioration hearing Such attacks can haunt the patient around the clock or occur spontaneously. This appears pathological process due to spasms in the ear vessels, which are a consequence of a failure in the circulation of the hearing aid. Over time, hearing loss develops (hearing acuity decreases) and if inflammation of the auditory nerve is not treated, the person will become completely deaf.

Initially, the symptoms affect only one ear, but as the disease progresses, it spreads to the healthy ear. Further, the patient begins to suffer from nausea, even vomiting and dizziness. Over time, a person’s hearing becomes worse and worse, and the manifestations of the disease intensify.

Acute neuritis of the auditory nerve is quite rare, and it is especially dangerous, since the symptoms develop at lightning speed and literally within 2-3 days the patient becomes completely deaf. This form of the disease is characterized by the following symptoms:

Rhinitis (runny nose);
Rapid increase in temperature;
High blood pressure;
Cough;
Hyperemia (overflow of blood);
Dizziness;
Failures in coordination of movements.

A painful attack occurs mainly due to rapid movements of the head, as well as during walking or bending. If the disease affects both ears, then the patient has difficulty speaking and must be urgently hospitalized. Treatment of acoustic neuritis in such a situation takes place exclusively in a hospital setting with the help of intensive care aimed at preventing hearing loss.

Diagnostics

An ENT doctor will have to diagnose cochlear neuritis after conducting all the necessary tests. The specialist will determine the cause of the pathological process, the degree of damage to the auditory nerve and prescribe a course of therapy.

Initially, the patient is examined and interviewed, and then instrumental methods for diagnosing deterioration of hearing acuity. One of them is pure-tone audiometry. It determines the threshold of frequencies that the patient can hear, as well as the degree of damage to nerve fibers. If signs of pathology (poor perception high frequencies) were found in both ears, this indicates the presence of pathology of the auditory nerve.
The doctor, relying on the results of the study, will prescribe a course of therapy and prescribe a hearing aid with the required frequency of perception. This procedure effectively helps even small children, since it can be performed during play or if the child is sleeping, and the examination is absolutely painless.

In case of head injury, brain tomography (computer, magnetic resonance imaging), as well as x-rays and encephalography are additionally prescribed. Such examination methods will allow the expert to assess the extent of damage.

Course of therapy

Understanding how to treat acoustic neuritis is quite difficult, because the course of therapy consists of a whole range of procedures aimed at restoring hearing. This cannot be done in all cases, since after typhus, malaria and others infectious pathologies Hearing loss occurs suddenly and people can become completely deaf in a matter of days. The same applies to the toxic effects of various toxic elements.

It is virtually impossible to restore hearing completely in such situations.

The course of therapy is drawn up by a doctor who selects procedures and medications depending on the cause of the pathological process:

If the culprit is viral infection, then medications with an antiviral effect are prescribed;
When neuritis is a consequence of bacteria, the doctor prescribes a course of antibiotics;
To treat the chronic form of the disease, it is necessary to additionally use iodine-based drugs and nicotinic acid, as well as glucose injections.

This type of pathology is treated by an audiologist. Patients, especially those with chronic cochlear neuritis, undergo routine diagnostics by this specialist at least 2 times a year.

For any pathogen, the patient’s body will benefit from vitamins to improve immune defense. In addition to them, a person suffering from acoustic neuritis must stay in bed constantly and drink plenty of fluids to remove toxins, for example, warm tea.

If head trauma is the main cause of nerve damage, treatment is symptomatic. It is necessary to take diuretics (diuretic medications) to reduce swelling and improve blood circulation. Medicines with anticonvulsant and analgesic effects will help eliminate a painful attack or spasm that occurs.

In case of poisoning toxic substances you need to take medications to remove them (sorbents) and sit on special diet. It should contain more vegetables and dairy products. Physiotherapeutic procedures and mud treatment have a good effect.

For blue-collar workers, the main factor influencing the development of pathology is poor working conditions. For example, construction workers are constantly in a noisy environment and experience vibrations. The problem can be eliminated by changing your place of work, since nerve inflammation cannot be cured otherwise.

If a person has completely lost their hearing due to an external stimulus, they will need a hearing aid. In addition, in case of an injury of this type, the patient is prescribed medications with a sedative effect, as well as to improve blood circulation. In any case, hearing acuity decreases over time and in old age it will be lower than at a young age. It is impossible to completely eliminate such consequences and older people will need to constantly monitor their blood pressure and cholesterol levels. After 60-65 years atrophic changes auditory muscles have chronic course.

Hearing prosthetics is usually prescribed by a specialist if the patient’s perception of sounds has decreased to 40 dB or lower and there are problems with speech, which is the reason for wearing a hearing aid. Prosthetics are performed individually depending on the degree of hearing impairment.

Sometimes ear treatment requires surgery. It is performed to remove tumors, hematomas, and also for implantation. If the patient is constantly bothered by ringing in the ears and dizziness, the doctor may amputate the tympanic plexus or perform a cervical sympathectomy (blocking the nerve trunk).

To protect the body from the effects of environmental irritants and to enhance the main course of treatment, the following procedures are prescribed:

Can accelerate the healing of nerve fibers and eliminate the inflammatory process mineral baths, treatment with healing mud and relaxation in a sanatorium;
Normalize physical and chemical properties nerve fibers can be treated with magnetic therapy;
You can improve nutrition and speed up regeneration using physiotherapeutic procedures such as electrophoresis, since electric field penetrates well into tissues;
To reduce pain and speed up the recovery of the auditory nerve, acupuncture can be used. In addition to it, acapuncture, phonopharesis and oxygen barotherapy have a good effect on damaged nerve fibers.

Often, complications can be avoided in any course of cochlear neuritis and for this it is enough to contact an ENT doctor in a timely manner for examination and examination. A timely course of therapy allows you to avoid hearing loss, but if the situation is advanced, then it is virtually impossible to completely restore hearing.

Traditional medicine methods

Get rid of acoustic neuritis with treatment folk remedies It will not work completely, but you can alleviate the condition and improve the effect of the main course of therapy. The use of such methods is allowed only after consulting a doctor.

The following traditional methods can be used as a supplement to the course of ear treatment:

The auditory nerve can be treated with a compress. It is based on crushed garlic and 2-3 drops camphor oil. The finished mixture should be placed on gauze and then applied to the ear. It is better to do this at night, and if a burning sensation occurs, you need to urgently remove the compress and rinse the auricle;
A decoction made from golden mustache can help relieve inflammation. To prepare, you need to take 3 leaves of this plant and pour 1 liter of them. water and then boil for 5 minutes. Next, the medicine should be allowed to brew for 24 hours, and then you can drink this remedy 3 times a day, 1 tsp.

Prognosis and prevention

With timely treatment, acoustic neuritis resolves without special complications. Basically, it is possible to restore hearing acuity entirely, but in some cases it is only possible to stop the pathological process and remove inflammation.

In a situation where the nerve began to die, the prognosis is extremely disappointing. The patient will most likely lose his hearing and in such a situation it is necessary to undergo a prosthetic procedure in order to regain the ability to fully perceive the world around him. The rhythm of life with a properly selected hearing aid will not change much and the person will be able to continue working and going about their business.

It is better to avoid pathology than to treat it, but to do this you must follow the rules of prevention:

Do not overcool;
Completely treat all pathologies of the ENT organs;
If the workflow takes place at constant noise, then you need to wear special headphones to protect your hearing;
Drink a vitamin complex, especially in spring and autumn;
Try to maintain a healthy lifestyle;
Do not use toxic drugs;
If the work is associated with a danger to the hearing aid, then you should undergo audiometry 2 times a year.

Acoustic neuritis is not fatal disease, but it can lead to disability, as hearing will gradually deteriorate. This can be prevented by following the rules of prevention, but if symptoms of the disease appear, you should contact an ENT doctor for examination.

The ear ganglion is relatively rarely the cause of neuralgic pain, but still, you need to be aware of this source of pain associated with the cranial nerves, especially since this type of neuralgia can simulate attacks, forcing the patient to consult an otolaryngologist in vain.

A little anatomy

The ear ganglion is a very compact but complex “communication hub”. It includes vegetative and sensory fibers. Let us list its functions, from this it will be clear what features will occur if it is defeated:

sensory innervation temporal - mandibular joint. All sensations, including pain that occurs when chewing, pass through this “relay”;
the ganglion provides sensitivity to the skin of the external auditory canal and temporal region;
its branches innervate the eardrum;
it supplies innervation to the parotid gland.

The picture shows an ear node

So, neuralgia of the ear ganglion (ganglion oticum) is a disease that occurs with attacks of acute, shooting pain in the ear and parotid area. Reflection of pain (irradiation) may extend to the arm, chest, but more often irradiation occurs in the neck, back of the head and lower jaw.

Nerve ganglia of the cranial cavity

A characteristic manifestation will be the appearance of hypersalivation during an attack of pain. Hypersalivation is in this case increased secretion of saliva. Additionally, there may be a feeling of stuffiness in the ear and the appearance of shooting pains. Hearing is not affected (unlike neuritis of the facial nerve, when in most cases hyperacusis develops).

It is precisely because many nerve fibers are involved in the anatomy of the ear node that it is necessary to make a correct diagnosis collaboration neurologist, dentist and otolaryngologist. This disease belongs to the group of vegetative ganglionitis, and is adjacent to the ciliary ganglion, submandibular and sublingual nodes. Autonomic disorders also cause cervical truncitis and ganglionitis of the superior cervical sympathetic ganglion.

Causes of the disease

Like other neuralgia of the cranial nerves, neuralgia of the ear ganglion occurs due to the occurrence of foci of painful impulses that form spontaneously as a result of the development of infection. Most often, the following diseases and processes lead to the development of painful attacks:

acute and chronic parotitis – inflammation of the salivary glands;
sialadenitis, stone formation in salivary glands ah with blockage of the ducts and the development of secondary inflammation;
chronic otitis, including purulent;
chronic tonsillitis (angina);
inflammation of the sinuses - frontal sinusitis, sinusitis, ethmoiditis and other sinusitis;
odontogenic diseases of the dental system and oral cavity - gingivitis, periodontitis, stomatitis.

As you can see, all these diseases are inflammatory. Secondary damage to the ear ganglion is also possible if the source of inflammation or purulent infection is distant from the skull. These may be diseases such as damage to the kidneys and urinary tract (pyelonephritis), septic lesions, pneumonia, including chronic, tuberculous processes. Also, the impetus for the development of many, including the ear ganglion, are such metabolic diseases, such as liver cirrhosis, chronic alcoholism, diabetes, chronic gastritis, chronic renal failure, in those cases when it develops.

Signs of damage to the ear ganglion

The most important and constant sign is severe pain in the area of the external auditory canal, somewhat anteriorly, as well as in the temple area and around the ear. Like all other neuralgic pains, it is very sharp, like a blow electric current, burning, pulsating and very unpleasant. It is capable of giving, as already mentioned, to the ear, jaw, and shoulder, respectively, to the side of the lesion. Also, symptoms of neuralgia of the ear node may be indicated by complaints such as.

What can trigger an attack of this pain? Most often, this is very hot liquid food - soup, tea, going out into the cold and wind with subsequent hypothermia of the face. Intense physical work with a rush of blood to the face (stooping work). This pain, like any other neuralgia, can be provoked by psycho-emotional stress. As a rule, an attack of such pain does not last long - a few minutes, and in any case its duration does not exceed an hour.

Sometimes changes in such factors can provoke an attack external environment like change atmospheric pressure(since the eardrum, whose innervation is connected to the ear ganglion, is sensitive to these vibrations). Somewhat less frequently, attacks are activated by changes in air temperature (usually a decrease) and humidity.

All of the above makes it clear that the favorite time of year for exacerbation of this type of neuralgia (as, indeed, for most others - and) is spring and autumn.

If the pain reaches a certain threshold, the muscles of the Eustachian (auditory) tube respond to it with a spasm. This spasm leads to a change in pressure in the pipe, and the eardrum, releasing excess air, produces a characteristic “click”. Sometimes a feeling of stuffiness in the ear may occur.

Increased salivation on the affected side during a painful attack is another characteristic feature this vegetalgia. During the “light” intervals, the function of salivation is not impaired.

How to diagnose auricular ganglioneuritis?

Clinically - based on the characteristic pattern of complaints. The diagnosis is confirmed by painful points on palpation of the head - Richet's point, as well as increased pain sensitivity and discomfort in the parotid region;
By performing a special blockade of the ear ganglion by introducing local anesthetic– novocaine or a smaller amount of lidocaine. This procedure, in addition to verifying the diagnosis, brings significant relief to the patient. The anesthetic is injected into the Richer point with a simple needle. The substance must be injected between the anterior cartilage of the external auditory canal and the process of the mandible without damaging the temporal artery.
To exclude signs of inflammation in the parotid salivary gland, a dentist must conduct an examination; an otolaryngologist examines for the presence of chronic inflammatory diseases ear, nose and throat.
A bilateral ultrasound of the parotid salivary gland is performed;
Magnetic resonance imaging of the brain is mandatory and bone structures skull, to exclude a volumetric process.

Treatment of ear vegetalgia

As always, the measures consist of emergency pain relief and general therapy, in which the underlying cause is treated and new attacks are prevented. Treatment is also considered effective if the duration of the “light” intervals increases.

With a purpose, as opposed to anticonvulsants for trigeminal neuralgia, ganglion-blocking drugs are used: pentamine, arfonade, pyrylene, benzohexonium. Good healing effect provide antispasmodics (No-Shpa, Halidor, papaverine hydrochloride). Unlike trigeminal neuralgia, with neuralgia of the ear ganglion muscle spasm plays a significant role in the pathogenesis of the disease. So, muscle relaxation auditory tube helps reduce pain and discomfort in the ear.

Sedatives (valerian, Persen - Forte, Phytosedan) and hypnotics (zopiclone (Imovan), donormil, phenazepam) are used. Previously, barbiturates were used (luminal, veronal, barbamyl, etaminal - sodium), but now, due to pronounced side effects, they do not apply.

According to the scheme, B vitamins are used (including nicotinic acid), electrophoresis is performed with novocaine or thiamine (vitamin B 1).

In the photo - The drug “Milgamma” - combination therapy with B vitamins

If salivation is severe, platyphylline is used to reduce secretion. An important link in treatment possible swelling is taking antihistamines.

Great importance is attached to physiotherapeutic procedures and methods: magnetic therapy, laser therapy, massage, acupuncture, electroacupuncture, biological heating active points wormwood cigars.

It should be noted that relapses of the disease are possible. To avoid them, you need to promptly sanitize the oral cavity, cure your teeth, try not to aggravate existing chronic diseases of the ENT organs, and monitor your blood sugar levels.

Neuralgia of the ear is symptomatically similar to purulent inflammation of the middle ear (otitis media), which is often associated with difficulty correct setting diagnosis. Feeling pain in the ear, the patient in vain turns to an ENT specialist, while only a neurologist can select methods for treating this problem.

The ganglion of the ear is a complex structure formed by autonomic and sensory nerve fibers. This nerve node performs the following functions:

responsible for the sensitivity of the temporomandibular joint;
responsible for the functioning of the salivary gland;
regulates the sensitivity of the external auditory canal.

This node or ganglion is responsible for the sensitivity of the area, so when it is damaged, pain is felt. With neuralgia of the ear, patients note the following symptoms:

shooting and sharp pain in the ear;
excessive salivation;
feeling of stuffiness in the ear.

Pain is often reflected in the lower jaw, which makes it difficult to make a diagnosis and determine the cause of the pain syndrome.

To make a diagnosis, consultation with three specialists is necessary - an otolaryngologist, a neurologist and a dentist, since the symptoms of neuralgia largely repeat the symptoms of otitis media and some dental diseases.

Reasons

More often, neuralgia of the ear node develops due to the presence of a source of infection in the body. The infection spreads throughout the body through the bloodstream and enters the area, causing an inflammatory process. The reason may be:

inflammation of the salivary gland;
blockage of the salivary glands;
chronic and purulent inflammation middle ear (otitis);
tonsillitis, including chronic ones;
sinusitis;
bacterial and infectious dental diseases.

In some cases, secondary inflammation of the ear nerve is observed. This is typical for diseases such as pneumonia, sepsis and kidney pathologies. Ear damage ganglion may be one of the manifestations.

Symptoms of the disease

Pain with neuralgia of the ear can radiate to the jaw, but more often patients notice pain in and around the ear auricle, extending to the temporal region.

The pain is paroxysmal, with a tendency to intensify under certain influences. A factor that provokes increased pain during neuralgia is the consumption of hot food.

Often the pain intensifies and becomes acute with strong psycho-emotional stress or stress. Attacks of pain are short-lived and can vary from a few minutes to one hour.

The eardrum is very susceptible to vibrations, so even a sudden change in atmospheric pressure can trigger a new attack of pain. Particularly often there is an increase in pain in humid weather.

Neuralgia of the ear node is considered a seasonal disease, since in most cases the problem becomes relevant in the fall and spring, when there is predominantly rainy weather and low air temperatures.

Attack of pain

The attack begins suddenly. Its onset is signaled by characteristic ear congestion. The pain has a wave-like character and during an attack it either intensifies or almost goes away. There is increased salivation and special sensitivity to loud sounds.

The attack ends suddenly, just as it begins, and with it it stops copious discharge saliva and feeling of stuffiness.

Making a diagnosis

To make a diagnosis, you must undergo the following examinations:

Brain MRI;
ultrasound examination of the salivary glands passing near the ear;
examination by an otolaryngologist;
dental examination.

Making a diagnosis is the task of a neurologist. The doctor will analyze the patient’s complaints and refer him to another specialist to rule out other pathologies with similar symptoms.

How to distinguish from otitis media

Neuralgia of the ear node is often mistaken for otitis media. To avoid this, you need to know the symptoms of middle ear inflammation:

increased body temperature;
fever and general weakness;
pain syndrome when trying to open your mouth wide;
discharge of pus from the ear canal;

With otitis, there is a prolonged aching pain with high fever. The ear stops hurting after a breakthrough, when pus begins to be released.

With neuralgia, the temperature does not rise. There is no fever or general weakness, but the pain is acute and appears periodically. Discomfort increases when eating hot food, and not when opening the mouth, which is typical for inflammation of the middle ear.

Treatment methods

The basis of therapy is analgesics and anti-inflammatory drugs. To reduce pain, taking painkillers with analgin or ibuprofen is recommended.

To relieve inflammation, medications containing diclofenac or ibuprofen are used. These nonsteroidal anti-inflammatory drugs also help relieve pain.

It's important to take antispasmodics. This helps relieve muscle spasm of the auditory tube, which accompanies neuralgia and increases discomfort. Taking such drugs helps to quickly improve the patient's well-being.

To improve the patient’s well-being and speed up recovery, the use of sedatives. They help normalize sleep and strengthen nervous system, which reduces the frequency of pain attacks and speeds up recovery.

The therapy is supplemented with B vitamins to improve the restoration of nerve fibers. Often prescribed vasodilators, for example, with nicotinic acid, to improve local blood circulation and relieve spasms.

If for any reason drug treatment impossible, physiotherapy is used - acupuncture, amplipulse, electrophoresis. This helps reduce pressure on the nerve, improve local metabolic processes and relieve the inflammatory process.

Blockade for neuralgia

Drug blockades are a method of long-term pain relief based on the injection of medication directly into the area of the affected nerve. For neuralgia of the auricular nerve, this method is one of the methods for making a diagnosis, since in case of otitis media, administering medication to the area of the nerve does not relieve pain.

Novocaine is usually used for pain relief. This helps relieve pain for several days. The blockade is used when the pain syndrome cannot be relieved with analgesics in tablets. The blockade does not replace therapy with anti-inflammatory drugs.

What to remember

For neuralgia of the ear, traditional methods of treatment based on exposure to heat cannot be used. Warming up in this case can provoke the spread of the inflammatory process.

If ear pain suddenly appears, and there are no symptoms of a cold or general malaise, you should first consult a neurologist. If discomfort is accompanied by an increase in temperature, you need to be examined by an otolaryngologist.

Often neuralgia of the ear becomes a constant companion for the patient. Due to the fact that the pain goes away on its own and the attacks do not last long, patients prefer not to pay attention to the discomfort. This approach is incorrect, since any disease should be treated in a timely manner.

Acoustic neuritis (synonym: cochlear neuritis) is a disease characterized by the development of an inflammatory process in the nerve that provides hearing function.
Sometimes acoustic neuritis is called sensorineural hearing loss, but this is incorrect. Sensorineural hearing loss is a hearing loss caused by damage to the nervous system, and acoustic neuritis is one of its causes.
The worldwide prevalence of hearing loss caused by damage to the auditory nerve is approximately 6%. The disease is most common among people over 55 years of age. Men are more often affected.
Acoustic neuritis and its consequences are more common in large cities than in rural areas. This is due to the fact that in the city the human ear is constantly exposed to background noise, which is much stronger than the natural noise that the ear is accustomed to.
Most often, young or middle-aged people with acoustic neuritis consult a doctor. Older people often do not give due importance to hearing loss and believe that this is normal for their age.

Anatomy and physiology of the auditory nerve

The auditory nerve originates from hair cells that are located in the inner ear. Hair cells are essentially nerve receptors: they perceive vibrations of the filling inner ear fluids and generate nerve impulses.
The impulse generated by the hair cells is carried to the brain by the auditory nerve, which exits into the cranial cavity through an opening in temporal bone.
First, the auditory nerve enters the brain stem, where the primary, unconscious perception of sound occurs. The nerve signal then travels from the brainstem to the temporal lobes of the cerebral cortex, where it is recognized, processed by the conscious mind, and compared with other sensations. A person recognizes a sound and its source.
Anatomically, acoustic neuritis affects one of three structures:

hair cells;
auditory nerve;
nerve centers in the brain stem (subcortical hearing centers).

With all three lesions, hearing loss occurs due to disruption of the conduction of nerve impulses.

Head injury

During a traumatic brain injury, pathological changes occur in the cranial cavity:

circulatory disorders;
swelling, which varies depending on the severity of the injury;
pinpoint microscopic hemorrhages from capillaries or more massive ones from cerebral arteries.

If these changes affect the vessels supplying the auditory nerve, then after injury its neuritis develops. The development of the inflammatory process is typical for fractures of the base of the skull when the temporal blood is affected. The auditory nerve is damaged by the edges of bone fragments, infection and as a result of vascular disorders.

Occupational hazards

Acoustic neuritis is an occupational disease for people who have the following occupational hazards at their workplace:

Constant exposure to noisy conditions: work in workshops where presses and other equipment are installed that make a lot of noise. Typically, neuritis of the auditory nerve, and then hearing loss in these cases, develop gradually over time, with constant regular exposure to noise.
Acoustic trauma- acute impact on the ear of a loud sound. This is a short, loud sound that causes a strong increase in pressure in the ear and injury. A shot, whistle, etc. can act as a traumatic agent.
Effect of vibration on the body. Acoustic neuritis and hearing loss are manifestations of vibration disease. Her other symptoms: increased fatigue, headaches and dizziness, poor circulation in the hands and feet (pallor, coldness, pain, tingling and other unpleasant sensations).

Age-related changes in the body

A higher prevalence of acoustic neuritis among older people is associated with:

Arterial hypertension, hypertension. Poor circulation in all organs and systems is a typical complication of increased blood pressure. When the auditory nerve stops receiving enough blood, inflammation develops.
Poor circulation in the arteries of the brain. Most often it is caused by atherosclerosis and thrombosis of cerebral vessels as a result of their age-related changes.
Age-related changes in the hearing aid- most often occurs at the age of 60–70 years and is a natural phenomenon of aging of the body.
Consequences of a stroke.

Other reasons

In relatively in rare cases Acoustic neuritis develops due to allergic reactions. It can be a consequence of barotrauma (trauma caused by a sudden change in pressure), for example, in divers with decompression sickness.

Symptoms of acoustic neuritis

Characteristic symptoms Acoustic neuritis:

Hearing loss– associated with damage to the auditory nerve. The severity of hearing loss can vary widely from minor to complete loss. Usually there is a gradual decrease in the patient's hearing, which can lead to complete deafness. Timely contact with a specialist is important factor successful treatment of this disease.
Ringing or tinnitus- bothers the patient constantly, regardless of external stimuli. In complete deafness there is no ringing.
Dizziness and nausea, imbalance– these symptoms can occur if the inflammatory process simultaneously involves the vestibulocochlear nerve, which carries impulses from the balance organ to the brain.
Acute pain in the ears - characteristic at the time of acoustic trauma, as a consequence of mechanical damage.
Weakness, headache, pallor- may appear if toxic neuritis is caused by acute poisoning and the patient’s symptoms of general intoxication come to the fore. Nausea and dizziness in this case may worsen.
Increased blood pressure, symptom of “floaters before the eyes”- are noted if, in addition to everything else, disorders of the cerebral vessels are added.
Fever, general malaise, cough and runny nose- possible only if layered infectious processes, such as influenza or ARVI.

Acoustic neuritis can be unilateral or bilateral. In this case, hearing impairment and deafness develop in one or both ears.
The degree of sensorineural hearing loss is determined by an ENT doctor during a special study - audiometry:

I degree - the patient hears only sounds that are louder than 26 - 40 dB. He can hear whispered speech at a distance of 1 - 3 meters and spoken speech at a distance of 4 - 6 meters.
II degree - sounds quieter than 41 - 55 dB are not perceived. This corresponds to whispered speech at a distance of 1 meter and spoken speech at a distance of 1 to 4 meters.
III degree- hearing impairment up to 56 – 70 dB. The patient does not hear whispers at all, but can perceive spoken speech at a distance of 1 meter.
IV degree - hearing loss to 71 – 90 dB. It is diagnosed if the patient can fundamentally distinguish at least some sounds.
V degree - complete deafness.

Treatment of acoustic neuritis

Treatment of auditory nerve associated with infectious diseases

Viral diseases are treated antiviral drugs, bacterial infections- with the help of antibiotics. Select adequately antibacterial drugs only a doctor can do it after the bacterial culture and the sensitivity of microorganisms to antibiotics was determined.
In order to reduce the effect of viral and bacterial toxins on the auditory nerve, use:

Vitamins, primarily ascorbic acid. She is powerful antioxidant and prevents cell damage.
Drink plenty of fluids promotes the removal of viral and bacterial toxins from the body through urine.
The patient is prescribed rest; his nutrition during illness should be complete.

Treatment of auditory neuritis associated with intoxication

Treatment chronic poisoning various substances that lead to damage to the auditory nerve - long-term and complex process, including the following points:

the use of special antidotes - substances that bind and remove the toxin from the body;
symptomatic therapy - medications that help eliminate individual manifestations of intoxication;
physiotherapy, balneotherapy, mineral baths, mud therapy, stay in sanatoriums.

In case of acute poisoning, emergency medical attention is required. First aid is provided on the spot by the ambulance team, and then the patient is usually taken to the hospital. Treatment measures carried out:

detoxification therapy aimed at removing toxins from the body: intravenous infusions of fluids, special antidotes;
symptomatic therapy aimed at eliminating the manifestations of poisoning;
vitamins, medications that protect nerve cells and improve their functions;
if poisoning is accompanied by a condition clinical death, then resuscitation measures are carried out.

Skull injuries

Only timely treatment traumatic brain injury will help prevent the development of auditory neuritis and other complications. It must be carried out in a hospital. The doctor prescribes:

painkillers;
medicines which improve blood flow in the vessels of the brain;
diuretics that help relieve swelling in the cranial cavity.

All victims undergo an X-ray of the skull, ECHO-encephalography, and examination by a neurologist and ophthalmologist.
In the future, periodic medications are prescribed that improve blood circulation in the brain and function. nerve cells, vitamin mineral complexes.

Treatment of acoustic neuritis caused by occupational hazards

Treatment of acoustic neuritis and hearing loss caused by damage to the auditory nerve will have little effect if the person continues to work in conditions of increased noise and vibration. The most effective treatment measure in this case is to change the place of work to one where these occupational hazards will not be present.
As a specific and nonspecific therapy prescribe:

Vitamins- perform vital role V metabolic processes auditory nerve.
Biostimulants (adaptogens) and biologically active substances - increase the resistance of the auditory nerve to wide range harmful effects both physical and chemical nature.
Physiotherapeutic procedures (electrophoresis on the skull area)- under the influence electric field promotes the penetration of drugs to the auditory nerve through the skin.
Balneotherapy, spa treatment, the use of mud therapy and radon baths- have a general strengthening effect and promote healing processes in nerve fibers, including the auditory nerve.
Magnetotherapy- change in better side physical and chemical properties water structures, including nerves.
Acupuncture- provides therapeutic effect and helps relieve pain symptoms.

The patient must be registered with an audiologist and undergo courses of treatment 1 – 2 times a year. If occupational hazards lead to complete loss of hearing, hearing aids are provided.
For acute acoustic trauma, the following are used:

painkillers;
drugs that improve blood circulation in small vessels and the state of the nervous system;
sedatives;
use of antibiotics and antiseptics to prevent the development of ear infections;
V long term After an injury, physiotherapy, vitamins, and biostimulants are used.

Treatment of acoustic neuritis caused by age-related changes

Chronic neuritis of the auditory nerve, which is caused by age-related changes in the body, is treated with great difficulty. Typically, the patient takes medications for life:

antihypertensive drugs- used for high blood pressure;
drugs that lower blood cholesterol levels- prescribed for cerebral atherosclerosis;
medicines that reduce blood clotting- relevant in the presence of thrombosis or the risk of developing such;
medications that improve blood flow in the vessels of the brain- promote adequate delivery of oxygen and nutrients to the auditory nerve;
drugs that improve the condition and function of brain cells;
vitamins and biologically active substances;
physiotherapy;
spa treatment, balneotherapy.

Prognosis for acoustic neuritis

The prognosis for acoustic neuritis and sensorineural hearing loss depends on the form and stage of the disease, and the time of initiation of treatment.
In case of infectious diseases, injuries and acute poisoning, the prognosis in terms of hearing restoration is most often favorable. Deafness occurs only when the disease is severe and there is no adequate treatment.
With chronic diseases, the prognosis is usually less favorable. Complete hearing restoration is only possible with early start treatment when significant changes have not yet occurred in the auditory nerve. For age-related changes in the ear, use quality treatment The process can be slowed down, but not completely eliminated.

Prevention of acoustic neuritis

To prevent the disease, it is necessary to eliminate the factors that lead to its development:

Prevent and promptly treat all infectious diseases that affect the head, neck, and respiratory organs.
Avoid bad habits, contact with toxic substances, use protective equipment at work.
Avoid the use of antibiotics that are ototoxic in children.
People aged 40–50 years should undergo annual tests to control blood cholesterol and measure their blood pressure daily.
At production, measures must be taken to protect personnel from constant noise and vibration (earplugs, protective screens, etc.).

What traditional methods can be used to treat acoustic neuritis?

Acoustic neuritis is a disease that, in the absence of adequate treatment for a long time, leads to complete loss hearing By delaying a visit to the doctor, the patient only aggravates the problem.

Traditional medicine cannot be an alternative to treatment prescribed by a doctor. However, it can improve the condition and help cope with symptoms.

Before using any traditional methods, medicinal plants, biologically active additives If you have acoustic neuritis, be sure to consult your doctor.

How to restore hearing after acoustic neuritis?

If acoustic neuritis occurs long time, then hearing cannot be restored. Treatment in this case includes wearing hearing aid, cochlear implantation, periodic courses of therapy aimed at preventing further hearing loss.

Wearing a hearing aid

Indications for wearing a hearing aid for acoustic neuritis are determined by an otolaryngologist (ENT doctor) after examining the patient and audiometry– a special study that helps determine the degree of hearing loss.

It is important to choose and adjust your hearing aid correctly. This is done by a specialist using a special computer program.

A hearing aid for acoustic neuritis is worn like glasses for decreased vision - it is put on if necessary. Acoustic parameters must be tested once a year and service apparatus. If necessary, it is repaired.

Main models hearing aids :

BTE. The device consists of a plastic or titanium case (including a sound emitter, microphone and amplifier), located behind the auricle, and an earmold, which is usually made from a cast of the patient's ear.
Miniature BTE. Less noticeable compared to conventional earbuds.
In-ear. Such devices are almost completely invisible, since they are completely located inside the ear canal.

Cochlear implantation

The technique that is used for severe violations hearing when wearing a hearing aid is ineffective. Used cochlear implantation system, which includes the following parts:

electrode chain which is placed inside snails(an organ located inside the skull and containing auditory receptors);
receiver - implanted under the skin;
speech processor– a module that is attached to the hair or scalp, includes a transmitter, a microprocessor and a microphone;
compartments for battery or batteries;
additional accessories such as remote control.

Stages of cochlear implantation:

Selection of patients who need surgery. The level of hearing loss is determined using audiometry. Candidates are patients who have not responded well to hearing aids.
Operation, during which the cochlear implantation system is installed.
Postoperative rehabilitation. The doctor’s task is to teach the patient to live with the implanted system and prevent possible complications.

Antineuritis treatment

Once every six months, the patient undergoes treatment, which is necessary in order to prevent further hearing loss. The course of therapy usually includes:

drugs to improve blood supply to the auditory nerve;
diaphoretics and diuretics to remove toxins from the blood that damage the auditory nerve;
detoxification agents;
vitamins;
biostimulants.

Which doctor should I contact?

Acoustic neuritis is treated by two specialists:

Neurologist– specialist in the field of nervous diseases.
Otolaryngologist (ENT doctor)– specialist in the treatment of diseases of the ears and upper respiratory tract.

You can contact any of these doctors.

What to do if acoustic neuritis is detected in a child?

The most important thing is not to waste time! The success of treating the disease and the chances of restoring hearing directly depend on how early the diagnosis is made and therapy prescribed. You need to contact a neurologist or ENT doctor. The doctor will prescribe outpatient treatment or give a referral to a hospital.

The main task of the auditory nerve is to provide a person with the opportunity to hear the sounds of the surrounding world.

It originates in the middle ear, and its dendritic processes densely envelop all parts of the middle and inner ear, attaching to the temporal part of the brain and rooting in the gray matter. When a nerve loses its ability to conduct impulses, a person may have difficulty hearing.

There are many reasons for the development of deafness, but most often hearing loss is a consequence of the development of a protracted inflammatory process in the body. What is auditory neuritis, in what cases does it develop and how to deal with the disease, we will learn further.

Neuritis is an inflammatory process of the auditory nerve, in which its functions of transmitting nerve impulses to the cerebral cortex are reduced, resulting in a decrease in the quality of hearing.

Just a few decades ago, the disease was considered the prerogative of older people, in whom the development of deafness was explained by completely natural aging processes.

Now the disease is rapidly getting younger, since people do not seek help from specialists when they are ill, and are increasingly self-medicating.

Plus, provoking factors that increase the chances of developing neuritis play an important role: lack of hats in cold weather, poor hygiene, exposure to loud sounds that shake the eardrum (clubs, discos, city transport).

Pelvic neuralia is a pathology that is quite difficult to treat and also causes considerable discomfort for the patient. The article discusses the features of the course of the disease and treatment options.

Causes of hearing loss

There are several groups of reasons that can contribute to deterioration in sound quality:

The presence of inflammatory processes of infectious etiology in the ENT organs:

otitis;
acute respiratory infections and acute respiratory viral infections;
mumps;
rubella;
meningococcal infection.

Particularly dangerous are infections that have a chronic course, exacerbating periods. They can cause the development of complete deafness, when a person refuses the help of doctors for a long time, engaging in self-medication.

Head injuries that contribute to disruption of blood supply to the ear area, as a result of the development of swelling and inflammation.

Exposure to harmful substances:

alcoholic and nicotine addiction cause damage to the blood vessels of the brain, which affects the quality of hearing;
long-term use of antibiotics and antitumor drugs, which have increased toxicity;
salt and steam heavy metals, which accumulate in the body, settling on the walls of blood vessels and in the liver.

Availability chronic diseases cardiovascular system - when blood circulates in the body insufficiently, hypertension can develop, which is one of the precursors of the development of auditory neuritis.

The consequence of an allergic reaction occurring in over acute form(anaphylactic shock).
Consequences of a stroke, as well as problems with the strength of blood vessels in the brain.
Age-related changes in the body that occur against the background of the natural aging process, which reduces the conductivity of nerve fibers.
The harmful effects of external irritants: loud music, vacuum headphones, city noise.
Sudden changes in pressure associated with professional activity: among divers, military personnel on submarines, on board aircraft conductors.

Most often, the disease manifests itself in urban populations, where there is constant exposure to noise on the body.

Symptoms of inflammation of the ear nerve

Since the auditory nerve has two branches (vestibular and cochlear), deterioration in hearing quality is not the only symptom progression of neuritis of the auditory (ear) nerve.

In addition to hearing loss, a patient may experience symptoms of inflammation of the ear nerve, such as:

Ringing in the ears that bothers you throughout the day and even during sleep. May be replaced by noise, in which a person feels isolated.
Acute pain in the ears ( acute neuritis auditory nerve) – characteristic of head trauma, as well as exposure to loud sounds, which has a increased load on the eardrum and auditory nerve.
Nausea and dizziness - this symptom is often confused with a stroke or pre-stroke condition, but this may be a symptom of ordinary neuritis affecting the vestibular apparatus.
Impairment of balance and spatial position of the body is also associated with irritation of the vestibular process of the auditory nerve.
Pale skin, which is accompanied by a lack of appetite and general weakness, is characteristic of toxic neuritis, when the disease develops due to the harmful effects of toxins.

Additional symptoms that develop against the background of the progression of other diseases may include the following:

cough, runny nose and ear discharge;
increased blood pressure;
increase in body temperature.

Symptoms may vary depending on the stage of development of the disease and what was its root cause.

Making a diagnosis

By visual examination of the auricle it is impossible to determine neuritis.

The only diagnostic method is audiometry - a procedure in which sounds of different frequencies are delivered to the patient's ear.

As a result, neuritis can be differentiated by the degree of progression:

First degree - a person clearly hears sounds up to 40 dB, distinguishes whispers from 1-3 meters, as well as spoken speech at a distance of 4-5 meters.
Second degree - a person no longer hears sounds in the range quieter than 55 dB, which corresponds to colloquial speech at a distance of 1-3 meters.
Third degree - sound up to 65 dB is not perceived, and a person cannot hear a whisper, even when the source is close.
The fourth degree is determined by partial deafness, when a person is able to perceive only small sound waves, not less than 95 dB.
Fifth degree - characterized by complete deafness, when a person is unable to catch and distinguish any sounds.

The doctor examines the patient and identifies the root cause of hearing loss. This is what further treatment will depend on.

Treatment

How to treat acoustic neuritis? Drug treatment is mainly indicated.

Therapy is aimed at eliminating the pathogenic factor that provoked the development of neuritis, as well as restoring the functional abilities of the nerve itself.

It is important to take into account the etiology of the disease, since treatment in various cases has its own characteristics:

If you have acute respiratory infections and acute respiratory viral infections (flu, colds, meningitis), it is important to get rid of the infection by administering antiviral and antibacterial agents. Next, the functions of the auditory nerve are restored with the help of vitamin complexes and antipsychotics, which improve the conductivity of the nerve impulse.
If the cause of neuritis is a skull injury, painkillers and diuretics are used to reduce swelling meninges, as well as drugs that normalize the nutrition of nerve fibers.

In case of intoxication, it is important to reduce the harmful effects of toxins on the body, which is achieved thanks to:

antidotes that reduce the manifestation of intoxication;
diuretics that accelerate the removal of toxins from the body;
vitamin complexes that support all vital processes.

Treatment of neuritis, which has natural causes (age-related changes), involves the use of drugs such as:

medications that lower blood cholesterol levels;
blood thinners, which make the blood less thick, making it easier to pass through the vessels;
vascular strengthening drugs;
vitamin and mineral complexes that improve the functioning of nerve cells;
physiotherapeutic procedures.

Prevention

As preventive measures, you should adhere to the following recommendations:

Avoid long-term exposure noise, especially with loud music on headphones.
Wear a hat during the cold season that covers the ear area well.
Do not insert sharp objects into the ear canal, which can cause nerve injury.
Avoid contact with highly toxic substances.
Monitor your own health, preventing the transition to acute respiratory disease into a chronic form.
Give up bad habits, and also eat right, saturating the body with everything essential vitamins and minerals.
Do not abuse medicines and also avoid them long-term use without the doctor's knowledge.
Observe measures in hazardous industries personal protection without ignoring the wearing of a respirator and protective mask.

Forecast

The prognosis of acoustic neuritis depends on indicators such as:

The root cause is that the simpler the etiology of the disease, the greater the chances of full recovery. It is easier to cure an infection than to repair a skull injury.
Age – regeneration of nerve endings occurs faster in the young population than in older people.
The presence of chronic diseases - the more health problems a person has, the worse the prognosis.
Stage of the disease - what faster man turned to a specialist for help, the less advanced the disease and the greater the chance of full recovery hearing

The prognosis is considered most favorable when neuritis is caused by an infectious lesion of the ENT organs.

Things are somewhat worse with toxic damage body and injury, where there is no guarantee that hearing will return in full.

For complex flow infectious diseases, which become more complex old age and the presence of chronic diseases, the prognosis is the most disappointing.

Thus, acoustic neuritis can develop for several reasons, usually interconnected. The earlier treatment was started, the more favorable the prognosis for recovery. The risk group includes people over 65 years of age, whose regeneration processes slow down due to advancing old age.