Neuritis of the auditory nerve: symptoms, treatment

Neuritis of the auditory nerve is a "problem" of the inner ear and auditory nerve. The disease occurs often enough, especially in chronic form. The main symptoms of the neuritis of the auditory nerve are a decrease in the severity of hearing and the appearance of noise in the ear, which can be one- or two-sided. There are many reasons for this disease. For diagnostics, a number of additional methods of investigation are needed. Treatment of neuritis of the auditory nerve is largely determined by the cause that caused it. Most cases show vascular drugs, drugs that improve microcirculation, vitamins and antioxidants. This article contains information about everything that relates to the neuritis of the auditory nerve.

The synonym for "neuritis of the auditory nerve" is cochlear neuritis. Sometimes even in common people the neuritis of the auditory nerve is called sensorineural hearing loss. From the point of view of official medicine, the latter statement is not entirely correct. Sensorineural hearing loss is a decrease in hearing associated with the defeat of any nerve structures, from the receptor cells of the inner ear to the nerve cells of the brain. Neuritis of the auditory nerve involves the destruction of only the receptor cells of the inner ear and the nerve itself.

It should be said that the auditory nerve is an integral part of the VIII pair of cranial nerves (pre-vertebral-cochlear nerves), that is, its fibers pass in one bundle with the vestibular nerves. Therefore, quite often the defeat of the auditory nerve occurs simultaneously with the lesion of the vestibular conductors. And then, in addition to hearing impairment and the appearance of noise in the ears, there may be other symptoms (in particular, dizziness, nausea, vomiting, trembling of the eyeballs, imbalance and gait). But they have nothing to do directly with the neuritis of the auditory nerve.

Causes of the disease

Acute respiratory viral infections can be complicated by the neuritis of the auditory nerve.

What causes damage to the auditory nerve? There are quite a few reasons. They can be grouped approximately like this:

• infection (viral and bacterial). These are influenza, herpes, rubella, measles, mumps, syphilis, meningococci;
• cardiovascular disorders, that is, a violation of the blood supply to the inner ear and auditory nerve. Most often it is hypertensive disease, atherosclerosis of cerebral vessels;
• trauma to the skull, surgical interventions on the brain (in the area of ​​the temporal bone and brainstem), acoustic trauma and barotrauma (diving, air travel);
• toxic effects. Especially dangerous for the inner ear and auditory nerve are salts of heavy metals (mercury, lead), arsenic, phosphorus, gasoline, alcohol. To this same group can include drugs, such as antibiotics aminoglikozidovoy series (Gentamycin, Kanamycin, Streptomycin and others), antitumor agents (Cyclophosphamide, Cisplatin), preparations containing Acetylsalicylic acid;
• prolonged (professional) exposure to noise and vibration;
• tumors (most often - vestibular schwannoma and metastatic tumors).

Of course, this is by no means all causes of the loss of the auditory nerve, but the most common. Also, the appearance of neuritis of the auditory nerve can sometimes be "blamed" for diabetes, allergic reactions, autoimmune diseases (systemic lupus erythematosus, sarcoidosis and others). In some cases, the cause of hearing loss remains a mystery, and then the neuritis of the auditory nerve is considered idiopathic.

Symptoms

Hearing loss with neurosensory hearing loss is often combined with noise and ringing in the ears.

The disease is characterized by the appearance of only two symptoms:

• hearing loss;
• the appearance of additional sounds in the ears (noise, ringing, whistling and so on).

Hearing loss can affect one ear in a one-way process or both with a two-sided process. With a slight decrease in hearing in one ear with a slow development of the disease, this symptom may go unnoticed due to compensation of a healthy ear. Identify such changes can only be done with additional research methods (audiometry). And in general, the decrease in hearing may not be seen by patients. Especially when the disease occurs gradually and is not accompanied by other symptoms.

The appearance of additional sounds in the ear is almost always immediately noticed by the sick. This symptom sometimes leads them to the doctor, and even after the examination, a decrease in hearing is detected. Noise, ringing, whistling, tapping, rustling intensifies at night, when silence comes around. In fact, the intensity of these sound phenomena remains the same, simply against the background of a decrease in sounds from outside they seem stronger. If the hearing loss reaches the degree of deafness, then all additional sounds disappear.

All other signs of the disease (eg, fever, runny nose, dizziness, vomiting, headache and the like) are not specific, that is, in no way indicate a lesion of the auditory nerve. But they help to establish the true cause of the defeat of the auditory nerve.

If a hearing disorder occurs acutely, for several hours or a couple of days, then this indicates an acute auditory nerve neuritis. Most often, it is caused by viral or bacterial infections, trauma. If symptoms persist for more than a month, then they talk about the subacute course of the disease. When the signs of the disease are present for more than three months, then this is a chronic neuritis of the auditory nerve. Naturally, the earlier the disease is diagnosed, the greater the chances of getting rid of the disease.

Diagnostics

During the initial examination, the doctor can only suspect the defeat of the auditory nerve. To confirm this conjecture, a set of additional survey methods is required.

First of all, a patient with hearing problems with hearing is audiometry. The method is fairly simple, does not require special preparation of the patient. Audiometry allows you to determine the level and extent of hearing impairment (that is, it is related to the structures of the external or middle ear or to the inner ear and auditory nerve). Also, research methods such as auditory evoked potentials and neuroimaging (computed tomography or magnetic resonance imaging) may be needed. Neuroimaging methods allow us to clarify (or exclude) a number of reasons for the neuritis of the auditory nerve.

Treatment

In acute cases of hearing impairment, the patient is shown hospital treatment. In subacute cases the decision on this issue is taken individually, with a chronic form almost always begin with an outpatient examination and treatment. In acute and subacute cases, they try to restore hearing to 100%, in chronic cases it is often impossible to do this, so it is primarily about stabilizing the condition and preventing the progression of the symptoms of the disease. Therapeutic tactics are formed, first of all, proceeding from the established cause of the disease.

So, if the culprit is a viral infection, then antiviral drugs are prescribed. If a variant of the virus is established, then selective therapy is preferable (for example, if the auditory nerve is damaged by the herpes virus, Acyclovir drugs are prescribed). At a bacterial process antibiotics are shown. It should avoid the appointment of deliberately ototoxic drugs (aminoglycosides). Usually, in order to achieve a sufficient therapeutic concentration of the antibiotic, one must resort to high doses.

If the cause of hearing loss is poisoning by any toxic substance, then detoxification therapy (intravenous drip infusion of solutions of Rheopolyglucin, Ringer, physiological sodium chloride solution and so on).

In case of traumatic injuries, anesthetics and diuretics are indicated (the latter are prescribed to reduce the swelling of the auditory nerve). In autoimmune processes, hormonal agents are used.

Widely used drugs that improve blood flow and nerve nutrition. This group of vascular drugs and drugs that improve microcirculation (for example, Cavinton (Vinpocetine), Vazobral, Nicergoline (Sermion), Pentoxifylline (Trental)). As an antioxidant, Mexidol (Neurox, Mexicor), vitamins E and C can be used. The complexes of vitamins of group B (Milgamma, Benfolipen, Neuromultivitis and others) have a positive effect.

Sometimes it is possible to use drugs that improve the carrying out of impulses along the nerve. These are drugs such as Neuromidine (Amiridin, Ipigrix, Aksamon) and Proserin.

In the treatment of neuritis of the auditory nerve, non-medicamentous methods of treatment are actively used: electrophoresis with medications, acupuncture, hyperbaric oxygenation, magnetotherapy.

In cases where the cause of hearing loss is the primary tumor process, resort to surgical treatment. This can be a gentle stereotaxic operation (using a gamma knife) or a more traumatic craniotomy (when the skull is opened to get to the tumor).If the cause is metastasis of another tumor, it is usually limited to radiotherapy.

A complete loss of hearing on one or both ears puts the question of hearing care before the doctor. This direction is quite widely developed now, it helps people who have not heard for many years.

Prognosis and prevention of the disease

Acute forms of neuritis of the auditory nerve are well suited to conservative treatment, it is often possible to achieve complete restoration of the function of hearing. Subacute cases are difficult to predict. In the chronic course of the disease, treatment rarely leads to the restoration of lost functions. More often you can only stop or slow the progression of the process.

Prevention of neuritis of the auditory nerve is the conduct of a healthy lifestyle, hardening, rational nutrition. This all increases the protective properties of the body, thereby reducing the risk of viral and bacterial infections. When symptoms of the infectious process appear, one should not engage in self-medication (especially - do not take antibiotics on your own), but it is better to immediately seek medical help. In the presence of industrial hazards (contact with toxic substances, noise, vibration), it is necessary to observe occupational hygiene. Also relevant are measures to prevent injuries. Patients with vascular diseases, which can cause neuritis of the auditory nerve (for example, hypertension disease, atherosclerosis of cerebral vessels), it is necessary to deal with their treatment in the first place.

Thus, neuritis of the auditory nerve is a disease that can make a person disabled, depriving him of one of the most important senses. It should be remembered that timely access to medical care for the occurrence of symptoms characteristic of this disease, in most cases, allows you to defeat the disease at an early stage.

Surgeon-otorhinolaryngologist V. Stas tells us about the neuritis of the auditory nerve: