Features of vestibular function in patients with sensorineural deafness of vascular origin

Objective: to study the features of vestibular dysfunction in patients with sensorineural hearing loss of vascular origin, depending on the degree of discirculation in the main vessels of the head. Metods. We examined 60 patients with various degrees of sensorineural hearing loss with circulatory disorders in the vertebrobasilar system (VBS), including 36 (60%) women and 24 (40%) men. The average age of the surveyed was 49.9±1.89 years. All patients underwent audiometry in an extended frequency range up to 20 kHz, the study of acoustic stem evoked potentials, acoustic reflexometry. A caloric test was used to study experimental vestibular reactions, and the results were recorded using computerized electronystagmography. Results. According to the otoneurological examination, the patients were divided into 3 subgroups. Peripheral cochleovestibular syndrome (PCVS) was diagnosed in 14 (23%) patients, central cochleovestibular syndrome (CCVS) in 19 (32%), and combined cochleovestibular syndrome (CVS) was diagnosed in 27 (45%) patients. In the analysis of complaints presented by patients with SHD of vascular origin, the combined complaints of hearing deafness, tinnitus and neurological symptoms (headaches, amnesia, paresthesia, fatigue, etc.), as well as dizziness and neurological symptoms, significantly prevailed compared with individual complaints of hearing loss or dizziness (p < 0.05). An analysis of the asymmetry of the pathological process on the right or left side did not reveal significant differences, however, the proportion of patients with bilateral lesions in the subgroup with CCVS was significantly higher. If vestibular nystagmus is an unconditioned stem reflex, then optokinetic nystagmus is a product of the activity of the cerebral cortex and occurs with the active participation of the patient himself in the process of research. Conclusion. The obtained data were compared with the structural changes and hemodynamic parameters in the blood of vertebral arteries (VA) and internal carotid arteries (ICA), as well as magnetic resonance imaging of the brain (MRI).