The peculiarities of hemodynamic violations for patients with combat acoustic trauma and violations in the central departments of auditory analyzer in the dynamics of treatment
Authors: Shidlovskaya Tetiana A. , Shidlovskaya Tamara V. , Kozak Nikolay S. , Ovsyanik Kateryna V. , Petruk Lyubov G. 
Published: December 2022

The active combat actions in our country resulted in the increasing the risk of occurrence of the acoustics trauma, acubarotrauma. There is an increase of number of cases of combat acoustic trauma in servicemen and now this problem acquires a large value. The objective estimation of cerebral hemodynamics in patients with acoustics trauma, got in battle conditions, is a necessary condition for the effective complex treatment of sensorineural violations of hearing in such patients.
Aim: the examination of quantitative and qualitative indexes of rheoencephalography before and after the treatment of the sensorineural hearing loss (SNL) that is accompanied by violations in the central departments of auditory analyzer, in servicemen that got acoustic trauma in the real combat terms.
Materials and methods: The 52 servicemen with acoustic trauma and 15 healthy persons were inspected.
There were analyzed 67 rheoencephalograms. Examinations were conducted by means of computer rheography
firm "DX systems".
Results and their discussions: During the quality estimation of rheograms of the inspected patient’s violation of circulation of blood of cerebrum was educed both in the carotid (FM) and in vertebral-basilar (OM) systems. Before the beginning of treatment, the normal indexes of the state of cerebral circulation of blood by data of REG did not register in any patient with acoustic trauma. The difficulty of venous outflow took place in 69,0% cases in the carotid system and in 87,0% in vertebral-basilar system. Among the investigated patients we also registered the decline of tone of cerebral vessels (15,0%) and cases of atony curve (23,0%). Only in 14,0% examined fighters we found the increase of tone of cerebral vessels with the phenomena of angiospasm. There was the considerable part of patients with unsteady vascular tone with inclination to the increase (41,0%) or decline (18,0%) in both systems of cerebral circulation of blood. In relation to the pulse blood filling, in patients with acoustic trauma there was more than half (51,0%) cases with its decline in the carotid system and (77,0%) in a vertebral-basilar pool. In the vertebral-basilar system in patients with acoustic trauma there was also marked asymmetry of REG-curves (13,0%).
After the treatment the improvement of quality indexes of REG took place. In the carotid system the percent of registration of unsteady vascular tone went down with inclination to the decline and cases of atony curve.
The patients with acoustic trauma after treatment had less of cases (33,0%) of declines of the pulse blood filling in the carotid system. The percent of asymmetry of REG-curves diminished also (3,0%) in both systems of cerebral circulation of blood.
In the inspected patients the changes of tone of cerebral vessels and difficulty of venous outflow, and also the declines of the pulse blood filling, took place both in carotid and in vertebral-basilar systems. This got the reflection in the quantitative indexes of REG: the changes of indexes α, dicrotic (DCi), diastolic (DSi) and rheographic (Rі) indexes of REG-curve in both systems of cerebral blood supply.
Conclusions:
The treatments of servicemen, that got acoustic trauma in the zone of battle actions must be as possible quicker and complex taking into account the data of audiometry and instrumental inspections, the cerebral circulation of blood.
Patients with acoustic trauma have unsteady or decreased tone of cerebral vessels, atony curve, fall-off of the pulse blood filling, difficulty of venous outflow. The most informing quantitative indexes of REG are DCi, DSi and Rі, that represent the presence of such changes of cerebral hemodynamics.
Conducted studies showed considerable violations of cerebral circulation of blood both in carotid and, especially, in the vertebral-basilar system in patients with acoustic trauma, got in the real battle terms.
The servicemen with battle acoustic trauma should be treated straightaway with the presence of initial sensorineural violations, it is necessary in time to begin a complex treatment taking into account the state of the auditory system and extra aural changes, first of all the cerebral circulation of blood. It will allow to warn the progression of auditory violations and forming the heavy sensorineural hearing loss.
The results of the objective state of cerebral circulation of blood for fighters with acoustic trauma can be useful in expertise questions.