Optimization of treating patients with chronic mixed cochleovestibular syndrome: descriptive study

OBJECTIVE. Study objective and subjective indicators of the auditory and vestibular functions of patients with mixed cochleovestibular syndrome before, during and after therapy. Based on the data obtained, optimize approaches to treat patients with this pathology.

MATERIALS AND METHODS. 842 patients were examined with the diagnosis: mixed cochleovestibular syndrome, the mean age of the examined group is 52. The duration of the disease was from 1 to 4 years. A comprehensive examination of patients was carried out проводили at key points of the study (inpatient: before initiation of drug therapy, in the middle and at the end of treatment course, and also outpatient monthly for 6 months.

RESULTS. Computer videonystagmography measures were the most sensitive and objective diagnostic method in this category of patients. Based on computer videonystagmography, data evaluation reveals the following patterns: by the main values, most changes are determined before therapy (point 1); during drug therapy (point 2, 3) videonystagmography values are almost unchanged, coinciding at point1; reduced imbalance in the vestibular system response is observed at points 4, 5 (the 3^rd and 4^th months of monitoring); at point 6 (the 6^th month) there are recorded changes in some values, which speak of onset of the disease exacerbation. When assessing other values (tonal threshold audiometry, vestibular passport, etc.) the findings of study methods were not sensitive to changes.

DISCUSSION. The evaluation of clinical guidelines did not find the optimal scheme of treating this pathology. We recommend treatment, which includes a comprehensive approach, consisting of a two-week course of parenteral drug injections (based on etiological reasons for the development of the pathological process) with physiotherapeutic procedures and vestibular rehabilitation measures, included in the treatment regimen. The repeated course of supportive therapy is recommended 6 months after the course of primary treatment.

CONCLUSION. The study has given and proven the optimal scheme of therapeutic measures and periods of preventive treatment. The recommended algorithm of guiding patients with mixed cochleovestibular syndrome will help to avoid the progression of the disease, achieve stable remission, to prevent complications and disability of patients. This strategy is also more economically beneficial.

marine medicine, cochleovestibular syndrome, vestibular dysfunction, sensorineural hearing loss, neurosensory hearing loss, vestibular system, examination, computer videooculography, prevention, treatment

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