INSTITUTE OF BIOMEDICAL RESEARCH OF VLADIKAVKAZ SCIENTIFIC CENTER OF THE RUSSIAN ACADEMY OF SCIENCES AND THE GOVERNMENT OF THE REPUBLIC OF NORTH OSSETIA-ALANIA

 

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PATHOGENIC MECHANISMS OF AUDITORY FUNCTIONS RESTORATION IN ACUTE PERIOD OF SENSONEURAL HYPOACUsis

 

Gappoeva E. T.


The functional and social rehabilitation of patients with auditory impairments of different level of severity is one of the most important tasks of modern otorhinolaryngology. The efficacy of  treatment  of different types of sensoneural hearing impairment in acute period is determined mainly by the possibility of hearing restoration with them and without treatment. The existing complex therapy of sensoneural hearing impairment and subjective ear noise including medication and physiotherapeutic treatment is characterized by low  efficacy. On this basis we conducted the analysis of adaptive possibilities of neuroendocrine system contributing to the restoration of hearing function which has great practical importance for   the further development of sensoneural hearing restoration therapy. The aim of our investigation was the determination of opioid and adenohypophysis-suprarenal system in the genesis of development and peculiarities of the course of sensoneural hearing impairment and on this basis elaborate corrective therapy with acupuncture use and pharmacological activation of nonspecific organism resistancy. According to our investigation, the prognostic criteria of hearing function restoration in patients with different forms of sensoneural hypoacusis in the acute period are the indices of basal concentration of  β-endorphin in blood plasma determined during the first decade of acute period. The increase of  basal concentration of  β-endorphin level in blood plasma is 3-5 times higher than normal indices (9-10 fmol/ml) in separate cases is favorable prognosis of hearing function restoration in patients with I-II level of hypoacusis and improving of hypoacusis in patients with III-IV level of hypoacusis. The data given above testify of endogenic opioid system participating in the genesis of all the forms of perceptive hypoacusis. Dysfunction of opioid and adenohypophysis-suprarenal systems appeared at the beginning of acute period is confirmed by hypercortizolemia, suppression of steroidogenic function of gonad (decrease of testosterone level in 2,6 times) and the activation of gonadotropins in male patients (increase of  LH level in 2-4,4 times). In female patients the concentration of FSH gonadotropic hormone had the tendency to be decreased (in 2,6 times) during the first decade of the disease, but the functional activity of gonad (estradiol level) remained on the level of lower normal limit. The treatment by electro stimulation with the following injection of auto serum in  biologically active points of  patients with acute sensoneural hypoacusis contributed to the stimulation of endogenic preventive mechanisms of  endocrine system and improving of hearing function.


Key words: sensoneural hypoacusis, opioid peptides, LH-luteinizing hormone, FSH-follicle-stimulating hormone.