No1(1) 2018
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DOI 10.37219/2528-8253-2018-1-17 |
Shydlovska ТА, Shydlovska TV, Kozak MS, Ovsyanik KV, Petruk
LG
Statе of bioelectric activity of the brain in persons who received acoustic
trauma in area of combat actions with a different stage of disorders in the
auditory system
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Shidlovskaya Tetiana A.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Chief Researcher, Laboratory for Occupational Voice and Hearing Disorders
(with phoniatrics group)
Doctor of Medical Sciences, Professor
E-mail: doctor_sh@ukr.net
Orchid ID: https://orcid.org/0000-0002-7894-359X
Shidlovskaya Tamara V.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Laboratory for Occupational Voice and Hearing Disorders (with phoniatrics
group)
Doctor of Medical Sciences, Professor
E-mail: doctor_sh@ukr.net
Kozak Nikolay S.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Laboratory for Occupational Voice and Hearing Disorders (with phoniatrics
group)
Leading Researcher
Doctor of Medical Sciences
E-mail: amtc@kndio.kiev.ua
Petruk Lyubov G.
Military Medical Clinical Center of the Southern Region
Department of Otorhinolaryngology
PhD
E-mail: amtc@kndio.kiev.ua
Orchid ID: http://orcid.org/0000-0002-1261-7054 |
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Abstract
Topicality: Providing medical care to patients with combat acoustic
trauma remains a topical issue of military medicine. There are works in the
literature that show changes in the central nervous system under the
influence of intense noise and at acoustic trauma, however, only in
individual studies this objective assessment of the functional state of the
central nervous system in patients with sensorineural hearing loss is shown
as well as the promising use of them.
Aim: is to determine the most significant indicators of bioelectric
activity of the brain according to the EEG in terms of prediction of the
course and ways of co-rejection of sensorineural hearing disorders in
persons who have received an acute trauma in the area of fighting.
Materials and methods: A group of servicemen with acoustic trauma was
examined with the most characteristic, typical forms of audiometric curves –
with a downward, precipitous type of the curve, which were divided into
three groups depending on the degree of severity of sensorineural deafness.
Group 1 – patients with initial non-expressed violations of the function of
sound perception in the basal part of the cochlea, group 2 – with a more
significant SDP accompanied by violations of speech and supra-vocal
audiometry, the 3 groups included patients with severe violations of
auditory function, lesions of the mediobasal part of the cochlea, often –
with a "break" of perception of tones in the conventional range. A total of
205 patients with acoustic trauma were examined. As a control group, 15
healthy normal people were examined.
The EEG study was carried out using the computer electroencephalometry of
the firm "DX-System" (Ukraine) according to the generally accepted
methodology according to the scheme of electrodes "10-20"
Results: In qualitative analysis of electroencephalograms, servicemen
with combat acoustic trauma revealed deviations from the norm in the
functional state of the central nervous system, expressed in varying
degrees, with the most characteristic decreasing of the bioelectric activity
of the brain, irritative changes, disorganization and desynchronization of
rhythms, more often in the temporal and frontal leads. The most significant
changes were in patients with more severe hearing impairment (group 3).
These changes indicate signs of severe cortex irritation and deep brain
structures in servicemen with acoustic trauma from the combat zone.
The analysis of EEG quantitative indicators showed that changes in the
bioelectric activity of the cerebral brain in patients with acoustic trauma
were manifested by deformation of the basic rhythm with modulation and
weakened response to functional loads, especially in the anterior leads.
Patients had the significantly (P<0,05) decreased percentage of alfa rhythm
in the normal picture of the EEG and the increased representation of beta
and delta rhythm, both in the background recording and in the functional
loading of photostimulations and hyperventilation . The most significant
(P<0,05) changes in bioelectric activity, in comparison with the control
group, were observed in individuals 2 and, personally, in 3 groups, with
more significant violations of auditory function.
We also conducted a comparative analysis of EEG quantitative indicators
among the study groups. The results of the research indicate a reliable
(P<0,05) difference in the indices in the groups, from the first to the
third group there was an increase in the representation of delta, theta and
beta rhythm, most in the forward projections, and the decrease in the
proportion of alpha rhythm. Moreover, these tendencies were maintained both
during the background recording and at the functional loads.
Conclusions: Thus, the servicemen with an acoustic trauma revealed
objective signs of functional disorders in the cortical and deep structures
of the brain. As the auditory function decreases in patients with acoustic
trauma and redistribution of the main EEG rhythms in the direction of the
growth of manifestations of slow-wave activity on a disorganized background
occurs, especially in the frontal and temporal infections. In the subjects
we surveyed with severe violations of auditory function, there are
significantly more significant changes in the central nervous system than in
patients with an initial SDE, which should be taken into account when
carrying out treatment and preventive measures aimed at rehabilitation of
the victims of combat operations with acoustic trauma. |
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Keywords
auditory analyzer, acoustic trauma, central nervous system, bioelectrical
activity of the brain. |
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