Disorder of sound conduction function in patients with COVID-19
Authors: Bezega Mychailo 
Published: August 2022

Topicality: Recently, due to the pandemic of the new virus COVID-19, a significant number of patients have been observed in almost all countries of the world, presenting various clinical manifestations of the disease. The auditory system can also suffer when infected with COVID-19. In the publications of several authors, observation of concomitant cochleovestibular manifestations in COVID-19 is presented. In addition, there are reports of sensorineural hearing loss, tinnitus, vertigo, otitis, and ear pain. However, there is still not enough information on auditory system lesions in patients with COVID-19 in the literature; so far, there are no thorough studies in this direction.
Aim: to investigate the state of auditory function in patients with COVID-19 with sound conduction disorders.
Materials and methods: An analysis of the clinical and instrumental examination results of 47 patients with COVID-19 with auditory function disorders was carried out. The results of the questionnaire, otolaryngological examination, subjective audiometry, and acoustic impedance measurement were analyzed. The investigation was carried out using audiometers АС-40 ("Interacoustics," Denmark), and MA 31 (Germany), impedance audiometers АТ-235, Ad 229e, ("Interacoustics," Denmark), and MAICO (Germany). In addition, an endoscopic examination of the nasal cavity was carried out using the workplace of an otorhinolaryngologist with the Mega Medical NET-1100 endovideo complex.
Results and their discussion: The analysis of the survey of 147 patients revealed that damage to the auditory system mainly occurred after a particular time after suffering from the disease due to COVID-19. Some patients (15.6%) had a progression of pre-existing SNS; in them, the first signs of deterioration of auditory function were usually noted a few days after the onset of the disease. In total, among 147 interviewed patients, 51 people (34.7%) indicated certain disorders of the auditory system. At the same time, the patients noted such symptoms as tinnitus, decreased hearing acuity, impaired speech intelligibility, poor tolerance to loud sounds, blocked ears, and unpleasant sensations in the ears (feeling of pressure, tingling, dull pain).
During the instrumental examination of 47 patients with COVID-19 with complaints from the auditory system, we mainly observed sensorineural disorders of auditory function. In 23.4% of cases, there was a conductive component. In the majority of such patients after COVID-19, they do not immediately notice symptoms in the auditory system. Instead, they have an unexpressed character and appear over time after the disease. Such hearing disorders are often accompanied by secretory otitis, tubootitis, and auditory tube patency disorder.
It should be noted that in patients (19.1%) with a conductive component, there were changes in the anatomical structures of the nose and nasopharynx in the form of curvature of the nasal foramen, hypertrophy of the nasal shells, tubular rollers, etc. Conservative therapy with vasoconstrictor, anti-inflammatory, and hormonal drugs is not always effective in such cases. In most cases, according to our observations, minimally invasive surgical intervention in the form of tympanopuncture was required.
Therefore, the disease of COVID-19 is often (34.7%) accompanied, in addition to other symptoms, by a decrease in hearing function. Lesions of the auditory system manifest in the form of perceptual disorders with a pronounced conductive component (23.4%).On the other hand, when presenting patients with persistent but vague hearing impairments, it should be borne in mind that this may be related to a previous illness of COVID-19. Elucidation of this circumstance is vital for prescribing adequate treatment and preventive measures.
Conclusions:
1. The disease with COVID-19 is often (34.7%) accompanied, in addition to other symptoms, by hearing impairment due to damage to the auditory system, both perceptual and conductive. Mainly, such manifestations occur after a particular time after the disease.
2. Hearing disorders with COVID-19 often have a conductive component (23.4% of cases). Such disorders can be observed directly during the disease and, in some patients, persist for a long time after recovery. Conductive disorders of auditory function can also develop somewhat delayed from the onset of the disease, have an indistinct protracted nature, and the manifestations can intensify even after the end of the active phase of the disease.
3. Conductive disorders of auditory function in COVID-19 are poorly amenable to traditional conservative treatment methods and require more active measures, including minimally invasive surgical intervention in the form of tympanopuncture.
4. For patients with COVID-19 who have complaints of hearing impairment, it is advisable to undergo an instrumental audiological examination.