The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.
Диагностика слуховых нарушений в современной ау-диологии представлена различными методами, позволяю-щими последовательно проводить дифференциальную диагностику уровня поражения слуховой системы [1,2]. Современные психоакустические методы широко ис-пользуются при исследовании состояния слуховой систе-мы больных. Однако эти методы являются субъективны-ми, поскольку исследуемый сам оценивает результат, что не применимо во многих случаях. Так, в вопросах экспер-тизы трудоспособности, при нарушении сознания вслед-ствие различных заболеваний и травм, при исследовании слуха у детей, в случаях недостаточности психического развития исследуемых, а также при проведении диффе-ренциальной диагностики ведущее значение приобретают именно объективные методы исследования слуха [3][4][5]. Благодаря научным достижениям последних лет в области физики и клинической аудиологии, большое распростра-нение в практике получил один из таких объективных ме-тодов исследования слуха, как акустическая импедансо-метрия -измерение акустического импеданса (АИ) коле-бательной системы уха. В настоящее время это исследова-ние занимает важное место в аудиологической диагности-ке, обеспечивая объективную оценку проводящей систе-мы среднего уха и частично проводящего пути слухового анализатора, предоставляя важную информацию для дифференциальной и топической диагностики наруше-ний слуха [2-4, 6, 7]. Тем не менее, учитывая широкое разнообразие патологии системы слуха, остается актуаль- The present review of the literature reports the materials concerning the application of the acoustic impedance measurements of normal ears and pathologically changed organs of hearing that are important for the differential diagnostics and monitoring of the hearing system condition during the conservative and surgical treatment.
The objective of the present work was to elucidate the characteristics of broad-band tympanometry in the healthy subjects with the unaffected hearing ability. The study involved 54 volunteers (27 men and 27 women) at the age from 21 to 55 years exhibiting no pathologic changes in the ear system as confirmed by the tone threshold audiometry, otoacoustic emission, tympaometry at a frequency of 226 Hz, and reflexometry. All the participants of the study underwent absorbance measurements by broad-band tympanometry within the frequency range from 226 to 8,000 Hz at an ambient pressure. Five parameters have been detected which reflected the major characteristics of the absorbance curve, such as the maximum sound power absorbance ratio; the frequency at which the ear structures absorbed the maximum sound power; the frequency at which the absorbance ratio bounces off the plateau; the frequency at which the absorbance ratio plummets to plateau; and the frequency range within which the absorbance ratio underwent the most pronounced changes. The results obtained in the present study give evidence of response stability and the absence of the statistically significant differences in the absorbance parameters between the men and women obtained by their analysis for the ipsilateral and contralateral ears.
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