METHOD FOR AUDITARY INEFFICIENCY REHABILITATION IN PATIENTS Russian patent published in 2017 - IPC A61F11/00 A61B5/12 A61N1/18 

FIELD: medicine.

SUBSTANCE: several stages are carried out in a certain sequence. Stage 1 is diagnostic, the form of auditary inefficiency, presence of otosclerosis and otosclerotic foci activity is determined according to the audiological research and CT of temporal bones with densitometry. In the presence of otosklerotic foci with density less than "+1000" HU, the presence of active otosclerosis form is detected, and in the presence of foci with density of "+1000" HU and more - inactive otosclerosis form is detected. When an inactive sensorineural form of auditary inefficiency is detected, a dynamic observation is performed with periodic audiologic examination, courses of vasoactive therapy. When inactive conductive or mixed forms of auditary inefficiency loss and bone-air interval (BAI) of 25-30 dB or more are detected in the speech frequency range of 0.5-4 kHz (SFR), one shall proceed with stage 3. If an active form of otosclerosis is detected, one shall proceed with stage 2. Stage 2 is conservative therapy: inactivating conservative therapy with courses of 1 to 4, and treatment duration depends on the otosclerotic foci density: "less +300 HU"- 4 courses "+300 ÷ 600 HU" - 2-3 courses, "+600 ÷ +900 HU" - 1-2 courses of treatment. Then the density of otosklerotic foci and BAI value are repeatedly determined: at otosklerotic foci density of "+1000 HU or more" and BAI value less than 25 dB for all forms of auditary inefficiency, one shall proceed with stage 4, and at BAI value of 25 dB and more in case of timpanal (conductive) or mixed forms of auditary inefficiency, one shall proceed with stage 3, at otosklerotic foci density of "less +1000 HU" for all forms of auditary inefficiency and BAI values, stage 2 is repeated. Stage 3 is surgical rehabilitation: stapedoplasty is performed, then in the distant postoperative period, the density of otosclerotic foci is determined. When active forms of otosclerotic foci are identified, stage 2 is carried out. When inactive forms with hearing thresholds less than 45 dB are identified, rehabilitation is considered complete. In case of hearing thresholds of 45 dB or more, one shall proceed with stage 4. Stage 4 is electroacoustic rehabilitation: the value of hearing thresholds is determined, and at a value of 45-90 dB, hearing aid is provided, and at a value of more than 90 dB, a cochlear implant is installed.

EFFECT: method provides compensation or restoration of damaged or lost hearing function due to the consistent application of a system of patient observation and treatment stages in case of otosclerosis, at the level of audiologist and otosurgeon, allowing to define an individual route of patient's rehabilitation considering hearing, forms of auditary inefficiency, otosklerotic process activity.

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