Labyrinthopathies

Description:

Those numerous pathological processes in an inner ear which are caused by disorders of trophic or vasculomotor character, and also the residual phenomena of inflammatory processes belong to labyrinthopathies (for example, after labyrinthites). Labyrinthopathies usually proceed chronically.

Symptoms of Labyrinthopathies:

The main symptom — the hearing impairment which is quite often followed by ear noise.

Some forms (for example, the progressing relative deafness) are characterized by the progressing deterioration in hearing, in other cases disease depends on that, as far as possible to eliminate the causal moment which worked chronically (for example, noise or toxic substances on production). Sharp falling of hearing under the influence of acute intoxication (for example, quinine) is quite often observed then the developed relative deafness can remain more or less stationary.

The diagnosis is made generally according to the anamnesis, to a normal otoskopichesky picture and the nature of a hearing impairment typical for damage of a sound receptor. Relative deafness of usually diskantovy type is expressed strongly and takes both ears.

Reasons of Labyrinthopathies:

When only the sound receptor is injured, it is possible to speak about cochleopathies; when (more seldom) pathological process takes only a vestibular mechanism, speak about vestibulopathies. At disorder of both functions the general term — the labyrinthopathy — most precisely corresponds to an observed picture.

Dystrophic process in kortiyevy body usually begins with voloskovy cells, nerve fibrils or cells of a spiral ganglion (preferential main curl).

Further it takes as well cells of the supporting device so eventually it is possible to speak about a degeneration (atrophy) of a kortiyev of body in general.

Such degeneration can arise under the influence of a number of exogenous and endogenous poisons (a toxic form). Intoxication salicylates, quinine, nicotine, methyl alcohol and a number of industrial poisons as, for example, gasoline, hydrogen sulfide, aniline, fluorine, sulphuric acid, mercury, arsenic, phosphorus, etc., and also poisonings with substandard meat, fish poison — all this can cause dystrophic processes in an inner ear. Toxins at scarlet fever, flu, malaria, typhus, diphtheria, measles, diabetes, pregnancy toxicoses, epidemic parotitis, intestinal dyspepsias, nephrites, gout, an epidemic craw etc. have not smaller value.

Sometimes the reason for the progressing dystrophy of a kortiyev of body remains to the unknown, for example at the progressing youthful relative deafness. More often this form begins at youthful age, but is sometimes observed and on average.

At all the diseases called above the vestibular nerve suffers or to a lesser extent, or is not surprised at all.

Very similar degenerative changes in a labyrinth take place at senile relative deafness (presbyacusis).

Dystrophic changes of a kortiyev of body are observed also at a chronic noise injury.

Degenerative processes in an auditory organ sometimes take place at hypovitaminoses and a hyponutrient (starvation), and not only in a snail, but also in the central departments of the analyzer to cortical cells inclusive.

Treatment of Labyrinthopathies:

Inside appoint drugs of calcium, iodine, strychnine, B1 vitamin. At senile relative deafness good results from use of sex hormones are sometimes observed.

The labyrinthopathy as an effect of radical operation meets very often and in a typiform. In these cases acoustical function not only does not keep at the previous (presurgical) level, but it begins to fall, and signs of damage of an acoustical receptor join symptoms of disorder of sound carrying out; relative deafness quite often reaches extreme degrees. Dizzinesses are observed, especially at sharp turns of the head, instability at the difficult movements; patients do not take out driving the bus, are very sensitive to rolling. Sometimes the weak spontaneous nystagmus is available. At a research of a vestibular analyzer it is found out that thresholds are raised (i.e. there is a decrease in touch sensitivity), but at the same time irritants of superthreshold force cause unusually strong reaction, preferential vegetative. Disproportionately strong reaction to small increase in force of an irritant turns out, thus. Such paradoxical reactions are characteristic of the parabiosis phenomena in nervous tissue. They, as we know, are characteristic also of damage of a sound receptor where the small gain of intensity of a sound is perceived by a sore ear unusually loudly.

Many factors participate in a labyrinthopathy pathogeny after radical operation. The main thing from them is the disturbance of exchange processes depending on vascular and trophic frustration. At typical obshchepolostny operation (and after it most often labyrinthopathies are also observed) all mucous membrane of a drum cavity is carefully scraped out, and in the subsequent there is a replacement with her epidermis. It leads to disturbance of food of the subject bone tissue, in particular a labyrinth wall which vessels are reported with vessels of a mucous membrane of a drum cavity. At a scraping of a promontorium pl collapses. tympanicus with its sensitive and trophic fibers. At last, under the epidermis covering walls of a postoperative cavity the small cystous educations proceeding from the remains of a mucous membrane are quite often formed; these cysts are usually surrounded with a zone of the inflamed bone which can be a source of the induced reactive phenomena in a labyrinth. In the mechanism of deterioration in hearing extremely important place belongs to cicatricial changes in area of windows. Due to the disturbance of the transformational mechanism distinction in pressure upon both windows is lost that always leads to sharp falling of hearing.