Vestibular dysfunction in patients with sensorineural hearing loss following acoustic barotrauma

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.