Вестибулярна дисфункція у пацієнтів із сенсоневральною приглухуватістю при акубаротравмі

O. Ye. Dubenko; K. O. Shylo

doi:10.14739/2310-1210.2026.2.348929

Authors

O. Ye. Dubenko Kharkiv National Medical University, Ukraine https://orcid.org/0000-0002-4911-5613
K. O. Shylo Kharkiv National Medical University, Ukraine https://orcid.org/0009-0009-0300-1520

DOI:

https://doi.org/10.14739/2310-1210.2026.2.348929

Keywords:

sensorineural hearing loss, acoustic trauma, vestibular dysfunction, balance, stabilometry

Abstract

The ongoing war in Ukraine has led to an increased incidence of sensorineural hearing loss (SNHL) resulting from acoustic trauma caused by firearms or explosions among both military personnel and civilians. This type of trauma is a significant contributing factor to the rising disability rates associated with impaired auditory and vestibular functions.

Aim. To determine the frequency and characteristics of vestibular dysfunction in patients with SNHL resulting from acoustic trauma.

Materials and methods. A total of 52 patients with SNHL due to acoustic trauma were examined, including 32 with acute and 20 with chronic forms of the condition. The study protocol comprised neurological, somatic, and otoneurological examinations, as well as audiological evaluation (pure-tone audiometry), brain neuroimaging, and stabilometry.

Results. Patient complaints included hearing loss, tinnitus, dizziness, headache, general fatigue, gait instability, ear fullness, and nausea. A correlation analysis between hearing thresholds and stabilometric indicators revealed a positive correlation with the Romberg coefficient for oscillation trajectory length at high frequencies (R = 0.407, p = 0.022921) and with the Romberg coefficient for sagittal oscillation amplitude at medium frequencies (R = 0.493, p = 0.004874). In patients with chronic SNHL, the integral hearing threshold (averaged across all frequencies) significantly correlated with maximum oscillation amplitudes in the frontal (R = 0.622, p = 0.004452) and sagittal planes (R = 0.572, p = 0.010530) under eyes-open conditions. Three key phenomena were identified in this group: the dominance of frontal instability, the role of the speech frequency range as a marker of decompensation, and the formation of a stable pathological pattern of lateralized instability.

Conclusions. In patients with acoustic trauma-induced SNHL, there is a clear positive correlation between hearing threshold shifts and the severity of the vestibular deficit. Stabilometric parameters show higher Romberg coefficient values, indicating that these patients rely more heavily on visual input to maintain postural balance.

Author Biographies

O. Ye. Dubenko, Kharkiv National Medical University

MD, PhD, DSc, Professor of the Department of Neurology and Child Neurology; Senior Researcher, Department of Radiation Pathology and Palliative Care, State Organization “Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine”, Kharkiv

K. O. Shylo, Kharkiv National Medical University

MD, Postgraduate Student at the Department of Neurology and Child Neurology

References

Vlajkovic SM, Thorne PR. Molecular Mechanisms of Sensorineural Hearing Loss and Development of Inner Ear Therapeutics. Int J Mol Sci. 2021;22(11):5647. doi: https://doi.org/10.3390/ijms22115647

Ghazaryan V, Sutton AE, De Jong R. Acute Acoustic Trauma. [Updated 2024 Nov 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK609092/

Joseph AR, MacGregor AJ, Dougherty AL. Pre-Existing Audiometric Hearing Loss is a Predictor of Significant Threshold Shift Following Injury During Combat Deployment. Ear Hear. 2023;44(5):1173-81. doi: https://doi.org/10.1097/AUD.0000000000001359

Myers EE, Joseph AR, Dougherty AL, Clouser MC, MacGregor AJ. Relationship Between Tinnitus and Hearing Outcomes Among US Military Personnel After Blast Injury. Ear Hear. 2023;44(2):300-5. doi: https://doi.org/10.1097/AUD.0000000000001285

Zozulya IS, Volosovets AO, Zozulya AI. [Injuries of the skull and brain: diagnosis and emergency medical care at the different stages of evacuation]. Ukrainskyi medychnyi chasopys. 2022;(5):69-74. Ukrainian. doi: https://doi.org/10.32471/umj.1680-3051.151.234471

Kaliyappan K, Nakuci J, Preda M, Schweser F, Muldoon S, Krishnan Muthaiah VP. Correlation of Histomorphometric Changes with Diffusion Tensor Imaging for Evaluation of Blast-Induced Auditory Neurodegeneration in Chinchilla. J Neurotrauma. 2021;38(23):3248-59. doi: https://doi.org/10.1089/neu.2020.7556

Shirbhate PA, Goel MD. A critical review of blast wave parameters and approaches for blast load mitigation. Arch Comput Methods Eng. 2021;28(3):1713-30. doi: https://doi.org/10.1007/s11831-020-09436-y

Paik CB, Pei M, Oghalai JS. Review of blast noise and the auditory system. Hear Res. 2022;425:108459. doi: https://doi.org/10.1016/j.heares.2022.108459

Blavt O, Zahura F, Helzhynska T, Khimenes K, Huska M, Gurtova T, et al. Defining Authenticity of the Y Balance Test Implemented by an Intellectual Programmed Tool in Inclusive Physical Education. Physical Education Theory and Methodology. 2025;25(4):945-53. doi: https://doi.org/10.17309/tmfv.2025.4.24

Crampton A, Teel E, Chevignard M, Gagnon I. Vestibular-ocular reflex dysfunction following mild traumatic brain injury: A narrative review. Neurochirurgie. 2021;67(3):231-7. doi: https://doi.org/10.1016/j.neuchi.2021.01.002

Akin FW, Murnane OD, Hall CD, Riska KM, Sears J. Vestibular and balance function in veterans with chronic dizziness associated with mild traumatic brain injury and blast exposure. Front Neurol. 2022;13:930389. doi: https://doi.org/10.3389/fneur.2022.930389

Blavt O, Gurtova T. Physical Education in the Restoration of Damaged Functions in Students After Blast Tbi Complicated By Acuborotrauma. Journal of Learning Theory and Methodology. 2024;5(2):56-63. doi: https://doi.org/10.17309/jltm.2024.5.2.02

Feller JJ, Duff MC, Clough S, Jacobson GP, Roberts RA, Romero DJ. Evidence of Peripheral Vestibular Impairment Among Adults With Chronic Moderate-Severe Traumatic Brain Injury. Am J Audiol. 2024;33(4):1118-34. doi: https://doi.org/10.1044/2024_AJA-24-00058

Gallamini M, Piastra G, Lucarini S, Porzio D, Ronchi M, Pirino A, et al. Revisiting the Instrumented Romberg Test: Can Today's Technology Offer a Risk-of-Fall Screening Device for Senior Citizens? An Experience-Based Approach. Life (Basel). 2021;11(2):161. doi: https://doi.org/10.3390/life11020161

Hupfeld KE, McGregor HR, Hass CJ, Pasternak O, Seidler RD. Sensory system-specific associations between brain structure and balance. Neurobiol Aging. 2022;119:102-16. doi: https://doi.org/10.1016/j.neurobiolaging.2022.07.013

Mallinson A, Maire R, Beyaert C, Vibert D, Coffinet L, Longridge N, et al. Understanding and Managing Trauma-Induced Vestibular Deficits. J Int Adv Otol. 2021;17(6):559-65. doi: https://doi.org/10.5152/iao.2021.21258

Martini DN, Parrington L, Stuart S, Fino PC, King LA. Gait Performance in People with Symptomatic, Chronic Mild Traumatic Brain Injury. J Neurotrauma. 2021;38(2):218-24. doi: https://doi.org/10.1089/neu.2020.6986

Teshchuk VJ, Teshchuk NV, Russkykh OO, Hlukhykh OP, Maksiutov OO. [Features of the course of acubarotrauma associated with brain concussion in military servants of the armed forces of Ukraine during the full-scale Russian-Ukrainian war of 2022]. Herald for maritime medicine. 2023;(2):3-13. Ukrainian. doi: http://dx.doi.org/10.5281/zenodo.8171215