Abstract | Ciljevi: Cilj ovog istraživanja bio je istražiti specifičnosti audiovestibularrnih simptoma,
razliku u audiovestibularnim simptomima među spolovima i dobnim skupinama i utvrditi
glavne karakteristike i specifičnosti u nalazima tonske audiometrije i vestibulometrije u post-
COVID bolesnika.
Materijali i metode: Radi se o retrospektivnoj studiji u kojoj su korišteni i obrađivani podatci
bolesnika iz protokola Zavoda za audiologiju u razdoblju od 01.01.2021. godine do 01.01. 2022.
godine. Radi se o 136 ispitanika između 20 i 86 godina života koji su podijeljeni u 3 dobne
skupine, a koji su tri mjeseca nakon SARS-CoV-2 infekcije imali simptome gubitka sluha,
tinitusa i vrtoglavice. Svima su se simptomi javili tijekom aktivne faze bolesti, a bili su prisutni
i tri mjeseca nakon infekcije. Svim ispitanicima urađena je tonska audiometrija, a onima s
vrtoglavicom i vestibulometrija. Kriteriji isključivanja: pacijenti mlađi od 20 godina i stariji od
86 godina, pacijenti s kroničnom akustičnom traumom, kroničnom upalom uha, prethodnom
operacijom uha, otosklerozom, traumom glave, Menierovom bolešću i prethodnim
vestibularnim poremećajima.
Rezultati: U skupini od 136 ispitanika prema uniformnoj razdiobi najčešće se radilo o
novonastalom (χ2=42; P<0,001) i obostranom (χ2=29,7; P<0,001) šumu. Prema uniformnoj
razdiobi gubitka sluha najčešće se radilo o postupnom (χ2=55,5; P<0,001) i obostranom
(χ2=22,8; P<0,001) gubitku sluha. Najveći broj ispitanika u ovoj skupini bio je bez vrtoglavice
(χ2=80; P<0,001). U skupini ispitanika koji su imali vrtoglavicu (BPPV i vestibularni neuronitis
zajedno; n=42) češći je BPPV koji se pojavio u 27 ispitanika (64%). Po dobi dokazali smo
statistički značajnu razliku razdiobe prema šumu (χ2=28; P<0,001), strani pojave šuma
(χ2=11,4; P=0,023), vrtoglavici (χ2=16,1; P=0,003), gubitku sluha (χ2=30,9; P<0,001) i prema
strani gubitka sluha (χ2=27; P<0,001). Po spolu nismo dokazali statistički značajnu razliku
razdiobe ispitanika prema šumu(χ2=0,103; P=0,950), strani pojave šuma (χ2=0,020; P=0,990),
vrtoglavici (χ2=5,3; P=0,070), gubitku sluha (χ2=2,5; P=0,287) i prema strani gubitka sluha
(χ2=1,07; P=0,585). U skupini ispitanika (n=136) najzastupljeniji je gubitak na frekvencijama
od 4 kHz (17,6%) i 4 i 6 kHz zajedno (16,9%), a najzastupljenije pojedine frekvencije su 4
(59,6%) i 6 (44,8%) kHz. Kod postupnog obostranog gubitka sluha (n=62) i kod obostranog
novonastalog tinitusa (n=56) najzastupljeniji je gubitak na frekvencijama od 4 i 6 kHz.
Zaključci: SARS-CoV-2 infekcija otkrila je nove kliničke manifestacije koje mogu trajati duže
od tri mjeseca. Iako smo otkrili povezanost između koronavirusa i gubitka sluha, šuma i
vrtoglavica, još uvijek ne znamo kolika je prevalencija jer je fokus bio na životno
ugrožavajućim stanjima, a poremećaji sluha i ravnoteže često nisu bili prepoznati kao simptomi bolesti ili su se ignorirali. Obostrani novonastali tinitus i obostrani postupni gubitak sluha su
najčešći audiološki simptomi, a najčešći vestibularni simptomi su BPPV i vestibularni
neuronitis. Nema značajne razlike u audiovestibularnim simptomima među spolovima, ali
postoji među dobnim skupinama. Glavne karakteristike i specifičnosti u tonskoj audiometriji
su obostrani senzoneuralni gubitak sluha u visokim frekvencijama na 4 i 6 kHz kod bolesnika
s postupnim gubitkom sluha i novonastalim obostranim tinitusom. U nalazima vestibulometrije
vestibularni neuronitis i BPPV su najčešći nalazi. |
Abstract (english) | Objectives: The aim of this study was to investigate the specificities of audiovestibular
symptoms, the difference in audiovestibular symptoms between gender and age groups and to
determine the main characteristics and specificities in the findings of pure-tone audiometry and
vestibulometry in post-COVID patients.
Materials and methods: This is a retrospective study in which patient data was collected from
the protocol of the Department of Audiology in the period from 01.01.2021. to 01.01.2022.
There was a group of 136 subjects between the ages of 20 and 86 that was divided into 3 age
groups, with symptoms of hearing loss, tinnitus and dizziness. All of them had symptoms during
the active phase of the disease and those symptoms were still present three months after the
infection. All subjects underwent pure-tone audiometry and those with vertigo underwent
vestibulometry. Exclusion criteria: patients younger than 20 and older than 86, patients with
chronic acoustic trauma, chronic otitis media, previous otosclerosis, ear surgery, head trauma,
Meniere's disease and previous vestibular disorders.
Results: In the group of 136 subjects, according to the uniform distribution, most common was
new-onset (χ2=42; P<0.001) and bilateral (χ2=29.7; P<0.001) tinnitus. According to the uniform
distribution of hearing loss, the most common was gradual (χ2=55.5; P<0.001) and bilateral
(χ2=22.8; P<0.001) hearing loss. The largest number of subjects in this group was without
dizziness (χ2=80; P<0.001). In the group of subjects who had dizziness (BPPV and vestibular
neuronitis together; n=42), BPPV was more common occurring in 27 subjects (64%). In the age
group there was a statistically significant difference in the distribution according to tinnitus
(χ2=28; P<0.001), the side of tinnitus occurence (χ2=11.4; P=0.023), dizziness (χ2=16.1;
P=0.003), hearing loss (χ2=30.9; P<0.001) and towards the side of hearing loss (χ2=27;
P<0.001). In gender group we did not find a statistically significant difference in the distribution
of subjects according to tinnitus (χ2=0.103; P=0.950), the side of tinnitus occurrence (χ2=0.020;
P=0.990), dizziness (χ2=5.3; P=0.070), hearing loss ( χ2=2.5; P=0.287) and towards the side of
hearing loss (χ2=1.07; P=0.585). In the group of subjects (n=136) the most common frequency
loss is at 4 kHz (17.6%) and at 4 and 6 kHz combined (16.9%), and the most common loss of
individual frequencies is at 4 (59.6%) and 6 (44.8%) kHz. In subjects with gradual bilateral
hearing loss (n=62) and bilateral new-onset tinnitus (n=56), the most common frequency loss
is at 4 and 6 kHz.
Conclusions: SARS-CoV-2 infection has revealed new clinical manifestations that can last
longer than three months. Although we discovered a connection between the coronavirus and
hearing loss, tinnitus and dizziness, we still do not know the prevalence because the focus was
on life-threatening conditions and hearing and balance disorders were often not recognized as
symptoms of the disease or were ignored. Bilateral new-onset tinnitus and bilateral gradual
hearing loss are the most common audiological symptoms and the most common vestibular
symptoms are BPPV and vestibular neuronitis. There is no statistically significant difference in
audiovestibular symptoms between gender groups, but there is between age groups. The main
characteristics and specifics in pure-tone audiometry are bilateral sensorineural hearing loss in
the high frequencies of 4 and 6 kHz in patients with gradual hearing loss and new-onset bilateral
tinnitus. In vestibulometry findings, vestibular neuronitis and BPPV are the most common
findings. |