Indicators of the peripheral and central departments of the auditory analyzer according to the threshold tone audiometry and acoustic impedansometry data in participants of combat operations with a different course of sensoneural hearing loss
Authors: Shidlovskaya Tetiana A. , Shidlovskaya Tamara V. , Kureneva Kateryna Yu , Shevtsova Tetiana V. , Poymanova Elena S. 
Published: February 2022

Aim: study of the characteristics of the acoustic stapedius-muscle reflex in conjunction with the data of threshold tone audiometry in combatants with different dynamics of the course of sensorineural hearing loss.
Materials and methods: The characteristics acoustic stapedius-muscle reflex and the indicators of threshold tonal audiometry in combatants with different dynamics of sensorineural hearing loss were conducted. 60 military personnel were examined: group 1, with positive dynamics after treatment, group 2, in which progression sensorineural hearing loss took place, 30 people per group.
Results and discussion: The study showed that patients who received combat acutrauma showed significant changes in the qualitative and quantitative characteristics of the acoustic stapedius-muscle reflex, which may indicate that they have disorders in the brainstem of the auditory analyzer. In patients with progressive sensorineural hearing loss, these disorders are more pronounced. Thus, they observed a significant (p<0.01) decrease in amplitude not only compared to the control, but also with the indicators of the group with positive dynamics. In addition, in the group with progressive course (group 2) there is a greater "dissociation" of acoustic stapediusmuscle reflex – a larger number of patients with no acoustic stapedius reflex, "asymmetric" acoustic stapediusmuscle reflex. When examining patients with combat acutrauma, we recommend examining both the peripheral (according to threshold tonal audiometry) and brainstem (according to acoustic stapedius-muscle reflex) department of the auditory system, which will not only identify disorders and prescribe the necessary treatment, but also assess the severity and predict the course of disorders in such patients. Therefore, acoustic stapedius-muscle reflex and its amplitude indicators should be used as diagnostic and prognostic criteria when conducting expert examinations of this category of patients.
Conclusions:
1. In combat acutrauma there are violations both in the peripheral department of the auditory analyzer according to the threshold tonal audiometry, and in the central (brainstem) according to acoustic stapedius-muscle reflex.
2. In combat acutrauma there is a significant (p<0,01) decrease in the amplitude of acoustic stapediusmuscle reflex, more pronounced in fighters with progressive SNP.
3. "Asymmetry" of acoustic stapedius-muscle reflex, pronounced decrease in the amplitude of the acoustic reflex, "dissociation" of acoustic reflex indicators with the results of audiometric examination is not only a typical sign of hearing loss in fighters with acute trauma, but can be a prognostic marker and one of the criteria disorders in this category of patients.
4. When examining patients with combat acutrauma, it is advisable to study the characteristics of acoustic stapedius-muscle reflex.