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"lead": "поражение вестибулярного нерва, предположительно имеющее воспалительный генез и проявляющееся единичным острым пароксизмом интенсивного головокружения с расстройством равновесия и полной сохранностью слуха",
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"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Этиофакторы вестибулярного нейронита не совсем ясны. Субстратом заболевания принято считать воспалительный процесс, избирательно поражающий вестибулярный нерв. Вероятнее всего, воспаление имеет вирусную этиологию. Это подтверждается манифестацией нейронита после перенесенных ОРВИ. Известны случаи, когда на фоне вестибулярного нейронита развивался герпетический энцефалит, в связи с чем предполагается, что одним из этиофакторов выступает вирус простого герпеса. В пользу инфекционной этиологии свидетельствуют описанные случаи заболевания сразу нескольких членов семьи.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Ряд авторов высказывается в пользу инфекционно-аллергического механизма развития вестибулярного нейронита, при котором вирусы являются сенсибилизаторами и провоцируют локальный аутоиммунный воспалительный процесс. Воспаление, как правило, затрагивает верхнюю ветвь вестибулярного нерва. Патология нижней ветви отмечается гораздо реже. Слуховой нерв остается полностью интактным. Кроме того, описаны случаи вестибулярного нейронита токсического генеза, обусловленного применением антибиотиков аминогликозидного ряда, в частности гентамицина.</span></p>",
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"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В подавляющем большинстве случаев диагностика основывается на типичной клинической картине. Диагноз можно подтвердить с помощью видеонистагмографии (регистрация движения глазных яблок при выполнении ряда тестов), теста импульсного движения головой (тест, оценивающий функциональность сразу 6 полукружных каналов — составляющей внутреннего уха, отвечающего за координацию) и пробы Фудуко (маршевая проба, в ходе теста оценивается отклонение пациента от первоначального положения). Кроме этого, у пациентов с ВН выявляется спонтанный горизонтально-ротаторный нистагм, усиливающийся при взгляде в сторону здорового уха.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Другие тесты и исследования, в том числе аудиометрия (исследование слуха) и МРТ головного мозга, выполняются по показаниям, для исключения других причин головокружения.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основные направления терапии пациентов с ВН — уменьшение головокружения, тошноты и рвоты (симптоматическое лечение) и ускорение вестибулярной компенсации.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптоматическое лечение включает использование лекарств, подавляющих вестибулярную функцию: антигистаминных средств (дименгидринат); бензодиазепиновых транквилизаторов (диазепам); противорвотных средств (метоклопрамида гидрохлорид, тиэтилперазин).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптоматическое лечение рекомендуют использовать не более 3 дней, поскольку оно замедляет вестибулярную компенсацию, что ведет к длительно сохраняющемуся головокружению.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эффективность глюкокортикостероидов, которые ранее активно использовались у пациентов с ВН, в настоящее время ставится под сомнение.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Несмотря на предположительную вирусную этиологию ВН, связанную, в частности, с вирусом простого герпеса 1 типа, применение противогерпетических препаратов также не ускоряет процесса выздоровления, и они не должны использоваться в лечении ВН.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для лечения ВН не рекомендованы пирацетам, трентал, мексидол, актовегин, кавинтон, глицин и прочие лекарства с недоказанной эффективностью.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Примерно с третьего дня заболевания пациентам с ВН рекомендуется вестибулярная гимнастика — упражнения, ускоряющие компенсаторные процессы, от более простых к более сложным. Это упражнения на фиксацию взора, тренировку глазодвигательных реакций, на удержание равновесия в различных позах стоя и в движении.</span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причин развития вестибулопатии учеными не установлено. Именно поэтому специальных профилактических мер для исключения возникновения нарушения не существует. Пациентам рекомендовано своевременно лечить инфекционные заболевания и соблюдать дозировку лекарственных препаратов, которую установил лечащий врач.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для ВН характерно монофазное течение — острое или подострое начало с последующим стиханием симптомов. Продолжительность клинических проявлений составляет в среднем от 1 недели до 3 месяцев (максимальные проявления — от нескольких дней до нескольких недель), после чего болезнь бесследно исчезает. Вероятность рецидива ВН составляет 2-5%.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Заболевание начинается с сильного головокружения, сопровождающегося нистагмом определенного вида. Головокружение усиливается при движениях головы и уменьшается при фиксации взора. В 78% случаев оно появляется внезапно, у 22% больных за 1-2 дня до дебюта заболевания отмечаются явления в виде неустойчивости и легкого нарушения координации движений. Часто наблюдается осциллопсия — нечеткое зрительное восприятие окружающих предметов при выполнении пассивных или активных движений головой вследствие нестабильности изображения на сетчатке. Резко нарушаются координация движений и равновесие. Почти у всех пациентов отмечается тошнота, у 65% — рвота.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В течение первых суток пациент лежит в постели — малейшие движения головой провоцируют тошноту, рвоту. На 2-5-е сутки больной способен перемещаться в пределах комнаты (палаты), однако сохраняется шаткость походки, а резкие движения головой или ходьба на большие расстояния провоцируют возникновение тошноты. На 10-14-е сутки пациент жалуется на «тяжесть» в голове, утомляемость, но в целом чувствует себя здоровым и может вернуться к привычному образу жизни.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В первые дни развития заболевания головной мозг «понимает», что вестибулярный аппарат транслирует неверный сенсорный сигнал: здоровый лабиринт всегда находится в активном состоянии, другой (пораженный) — угнетен, что интерпретируется мозгом как постоянное вращение в здоровую сторону. Поскольку восстановить проведение по пораженному вестибулярному нерву в короткие сроки невозможно, головной мозг блокирует активность здорового лабиринта, выравнивая потоки сенсорных сигналов от обоих вестибулярных аппаратов. По мере восстановления вестибулярного нерва система контроля возвращается в исходное, здоровое состояние.</span></p>",
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"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лабиринтит – это воспаление перепончатых образований и нервных структур внутреннего уха, вызванное различными вирусами, бактериями и их токсинами, а также травмой. </span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нередко причина заболевания остается невыясненной. Считается, что его могут вызвать патогенные вирусы, например, гриппа, или возбудители ОРВИ. Симптомы лабиринтита могут быть связаны с инфекцией микобактериями, стрептококками, менингококками.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Другие возможные причины, вызывающие асептическое (безмикробное) воспаление внутреннего уха:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ушиб, травма головы, сотрясение мозга;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">аллергическая реакция, например, при поллинозе;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">злоупотребление алкоголем;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">доброкачественное новообразование среднего уха (холестеатома);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">прием некоторых лекарств, таких как аспирин или фуросемид, в больших дозах.</span></li>\r\n</ul>\r\n<p> </p>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вследствие внутреннего расположения лабиринта его инфицирование с развитием лабиринтита возможно только при распространении микроорганизмов или их токсинов из других инфекционных очагов. Наиболее часто причиной лабиринтита бывает средний отит. В костных структурах улитки и преддверия имеются окна, которые закрыты соединительнотканными мембранами. Таким образом внутреннее ухо отделено от барабанной полости среднего уха. При воспалении среднего уха происходит набухание и инфильтрация мембран, в результате чего они становятся проницаемы для микробных токсинов, проникающих из барабанной полости и обуславливающих серозное воспаление внутреннего уха. Развивающийся серозный лабиринтит приводит к повышению давления внутри лабиринта, что может сопровождаться прорывом соединительнотканных мембран окон в барабанную полость. Через возникшие отверстия во внутреннее ухо попадают патогенные микроорганизмы, вызывающие развитие гнойного лабиринтита.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Инфекционные агенты и их токсины через внутренний слуховой проход могут проникнуть во внутреннее ухо из полости черепа. Причиной лабиринтита в таких случаях является менингит, который в свою очередь может быть обусловлен менингококковой и пневмококковой инфекцией, гриппом, корью, туберкулезом, скарлатиной, сыпным тифом. </span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В основе диагностики лежит тщательно собранный анамнез. На приеме врач проводит отоскопию (осмотр наружного уха и барабанной перепонки), оценку вестибулярной функции, аудиометрию (исследование слуха). Пациентам с подозрением на лабиринтит рекомендуется компьютерная томография височных костей или магнитно-резонансная томография головного мозга для выявления очага инфекции.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При исследовании слуха выявляется тугоухость смешанного типа, чаще с преобладанием сенсоневрального компонента.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В общеклиническом и биохимическом анализах крови выявляются характерные признаки воспаления (лейко- и лимфоцитоз, ускорение СОЭ, повышение концентрации С-реактивного белка).</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Медикаментозная терапия лабиринтита требует комплексного подхода. Она включает назначение антибактериальных и противовоспалительных препаратов, медикаментов, улучшающих кровообращение внутреннего уха, нейропротекторов, гипосенсибилизирующих средств. Купирование приступов головокружения при лабиринтите производится вестибулолитиками.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Тимпаногенный гнойный лабиринтит подлежит хирургическому лечению, которое заключается в проведении санирующей операции на среднем ухе, лабиринтотомии или пластики фистулы лабиринта. Если лабиринтит сопровождается мастоидитом или петрозитом, соответственно производится мастоидотомия или вскрытие пирамиды височной кости. При наличие внутричерепных осложнений лабиринтита показана лабиринтэктомия (удаление лабиринта) с дренированием полости черепа.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Стойкие нарушения слуха в результате перенесенного лабиринтита нуждаются в коррекции с помощью слухопротезирования или путем проведения слуховосстанавливающей операции (кохлеарной имплантации). С целью выбора оптимальной для пациента методики слуховой реабилитации необходима консультация сурдолога и слухопротезиста.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Профилактика лабиринтита сводится к своевременному и правильному выявлению воспаления среднего уха (средний отит).</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Также необходимо дезинфицировать нос, оральную и носовую часть глотки. Санация —лечебно-профилактические меры по оздоровлению организма. Во время санации лор-органов (носовой полости, носовых пазух, глотки, гортани, ушей) разрушаются микроорганизмы, которые живут там и могут привести к различным заболеваниям при ослабленном иммунитете.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее частые симптомы лабиринтита:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">головокружение, тошнота и рвота, не приносящие облегчения;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">потеря равновесия, неожиданные падения;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">умеренная головная боль, звон или шелест в ухе, потеря слуха;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">нистагм – движения глазных яблок в сторону поражения при серозной форме или в здоровую сторону – при гнойном варианте течения.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эти признаки усиливаются при движении головой, поворотах и взгляде вверх. Они могут сохраняться в течение нескольких дней или даже недель в зависимости от степени тяжести болезни. Даже после начатого лечения лабиринтита его симптомы могут рецидивировать, поэтому больному следует быть осторожным при вождении автомобиля и работе на высоте в течение как минимум недели после выздоровления.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Случаи, требующие срочной консультации специалиста и лечения лабиринтита:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">рвота, затрудняющая прием пищи, воды или лекарств;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">лихорадка, боль в ухе, прогрессирующая потеря слуха;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">сильная головная боль или головокружение, сохраняющееся в течение нескольких часов или более;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">двоение в глазах, нарушение речи, слабость лицевых или скелетных мышц;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">недавно перенесенная травма уха или головы.</span></li>\r\n</ul>\r\n<p> </p>",
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"lead": "нарушение слуха, которое характеризуется затрудненным проведением звуковых волн к звуковоспринимающему аппарату",
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"etiology": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Сбой в системе звукопроведения может случиться как на этапе прохождения звуковой волны через наружное ухо, так и на этапе прохождения через среднее. Наружное ухо состоит из ушной раковины и наружного слухового прохода. Среднее ухо имеет ещё более сложное строение. Оно включает барабанную перепонку, слуховую (евстахиеву) трубу, слуховые косточки (стремечко, молоточек, наковальня). Всё вместе – это очень слаженная система. Даже незначительный сбой в работе одной из выше названных структур приводит к ухудшению слуха. Причинами нарушений в наружном ухе, приводящим к кондуктивной тугоухости, являются следующие заболевания и состояния: </span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">серные пробки; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">посторонний предмет, застрявший в слуховом проходе; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">наружный отит (или как его ещё называют «ухо пловца»); </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">экзостозы (образования новой костной ткани на поверхности кости доброкачественного характера); </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">остеомы слухового прохода (доброкачественная костная опухоль); </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">травмы наружного уха;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">атрезия слухового прохода (состояние, при котором полностью или частично отсутствует слуховой проход).</span></li>\r\n</ul>\r\n<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">При всех этих состояниях звуковая волна задерживается в наружном ухе и не может пройти дальше в среднее ухо. Бывают случаи, когда звуковая волна успешно проходит через наружное ухо, но встречает препятствие на уровне среднего уха. Причины кондуктивной тугоухости, вызванные нарушениями в работе среднего уха: </span></p>\r\n<ul>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">повреждения барабанной перепонки (разрыв барабанной перепонки может случиться из-за травмы уха, включая ковыряние в ухе острым предметом; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">акустической травмы, резких перепадов атмосферного давления, а также вследствие тимпаносклероза); </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">воспалительные заболевания среднего уха (различные виды среднего отита); </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">воспаление слуховой трубы (евстахиит, тубоотит); </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">отосклероз (патологическое разрастание костной ткани в ухе); </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">холестеатома (доброкачественное образование в среднем ухе);</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">блокировка просвета слуховой трубы разросшимися аденоидами; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">травмы уха с повреждением слуховых косточек. </span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В основе патогенеза кондуктивной тугоухости лежит дисфункция звукопроводящей системы – внешнего слухового прохода, барабанной перепонки, полости среднего уха и слуховых косточек, эндолимфы или мембран улитки. В норме все эти структуры отвечают за усиление и передачу звука к структурам системы звуковосприятия. Нарушение хотя бы одного из звеньев этой цепочки приводит к искажению колебаний и общему ухудшению слуха. Функция кортиевого органа, слухового нерва и задних отделов верхней височной извилины, отвечающих за восприятие и обработку услышанного, не нарушается. За счет этого у больных сохраняется нормальная костная проводимость звуков. В тяжелых случаях ее чувствительность превышает воздушную, из-за чего человек полноценно воспринимает только собственную речь.</span></p>\r\n<p><span id=\"docs-internal-guid-119b9fb3-7fff-7e9f-3603-a50b81959b20\"> </span></p>",
"diagnostics": "<p><span id=\"docs-internal-guid-819cf277-7fff-9b74-5732-1217120d8351\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Пациенту с подозрением на кондуктивную тугоухость проводят следующие мероприятия: </span></span></p>\r\n<ul>\r\n<li><span id=\"docs-internal-guid-819cf277-7fff-9b74-5732-1217120d8351\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">сбор анамнеза – доктор расспрашивает пациента о жалобах, о перенесённых заболеваниях, травмах, повреждениях уха;</span></span></li>\r\n<li><span id=\"docs-internal-guid-819cf277-7fff-9b74-5732-1217120d8351\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">отоскопия – осмотр ушной раковины, слухового прохода, целостности барабанной перепонки. </span></span><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">На этом этапе выявляют воспалительные процессы в наружном ухе, серные пробки, инородные предметы в слуховом проходе; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">исследование слуха при помощи камертонов, шёпотной речи; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">аудиометрическое исследование, позволяющее определить остроту слуха; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">тимпанометрическое исследование, помогающее изучить состояние среднего уха, степень подвижности слуховых косточек, состояние барабанной перепонки; </span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">при подозрении на наличие образований в ухе и изменения его структур проводятся рентгенологическое исследование, компьютерная томография, магнитно-резонансная томография.</span></li>\r\n</ul>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечебные мероприятия при этом заболевании направлены на устранение ведущего этиологического фактора, нарушающего звукопроведение. Таким образом, лечебная тактика сводится к применению фармакологических средств или проведению хирургического вмешательства. Основные методы лечения:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Фармакотерапия. Интенсивная антибиотикотерапия показана на ранних стадиях ухудшения слуха, возникшего в результате воспалительных заболеваний – внешнего или среднего отита, евстахиита. Как правило, используются антибиотики широкого спектра действия. При поражении слухового прохода показано промывание уха растворами антисептиков, назначение НПВС или глюкокортикоидов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Оперативное лечение. Хирургическая тактика может подразумевать извлечение инородного тела из уха, восстановление функций барабанной перепонки (мирингопластика, тимпанопластика), дренирование барабанной полости, протезирование слуховых косточек (оссикулопластика), удаление гнойных масс из сосцевидного отростка (мастоидотомия) и т. п.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Слухопротезирование. Применение слуховых аппаратов показано при развитии изменений во внешнем или среднем ухе, не поддающихся лечению. Искусственное усиление воспринимающих звуков компенсирует функцию звукопроводящей системы, за счет чего к человеку возвращается способность слышать.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Чтобы снизить риск развития тугоухости, важно вовремя пролечивать воспалительные процессы в ушах и носоглотке. Соблюдайте правильную гигиену ушей. Не ковыряйте в ухе посторонними предметами. Избегайте травм головы. И посещайте лор-врача в профилактических целях, чтобы диагностировать снижение слуха на ранней стадии.</span></p>",
"clinical_picture": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Самый главный признак кондуктивной тугоухости – резкое или постепенное снижение слуха. Пациент начинает хуже слышать шёпот и разговорную речь. Если вокруг шумно, становится трудно различить слова собеседника. Звуки воспринимаются нечётко, приглушённо. Отмечается заложенность ушей. Себя начинаешь слышать громче, чем всё, происходящее вокруг. В зависимости от причины, вызвавшей тугоухость, могут наблюдаться и другие признаки: </span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ухудшение слуха может быть односторонним или двусторонним; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">появление боли в ушах; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">повышение температуры тела; </span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">выделения из слухового прохода. </span></li>\r\n</ul>\r\n<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">Последние симптомы развиваются обычно на фоне воспалительных процессов в ушах.</span></p>",
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},
"code": "H90.5",
"name": "Нейросенсорная потеря слуха неуточненная",
"icd_name": "Нейросенсорная потеря слуха неуточненная",
"gender": 0,
"age_min": 1,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 1,
"slug": "h90.5_neyrosensornaya_poterya_sluha_neutochnennaya",
"lead": "нарушение слуха, возникающее при поражении звуковоспринимающей части слухового анализатора",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нейросенсорная потеря слуха - это </span><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">врожденное или приобретенное снижение слуха, обусловленное поражением структур внутреннего уха, центральных отделов слухового анализатора, преддверно-улиткового нерва.</span></p>\r\n<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\"> </span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Специалисты различают две категории причин заболевания – врожденные и приобретенные.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная нейросенсорная тугоухость бывает вызвана:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">аномалиями хромосом;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">доминантными генами глухоты у отца или матери;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">мутацией определенных генов;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">различные синдромы (Стиклера, Ушера, Пендреда и др.);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">нарушениями развития частей внутреннего уха;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">инфекционными болезнями у матери (сифилис, хламидиоз);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">врожденная гиперплазия эпителия в среднем ухе;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">алкоголизм матери;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">краснуха у матери во время беременности;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">преждевременные роды.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">К приобретенной нейросенсорной тугоухости приводят следующие факторы:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">длительное воздействие высокочастотного шума (проф. вредность);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">акустические травмы при однократном воздействии звука выше 90Дб;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">медикаменты с ототоксическим действием (некоторые салицилаты, антибиотики, диуретики при неправильном использовании);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">черепно-мозговые травмы;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">инфекционные заболевания (вирусы и бактерии);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">опухоли;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">аутоиммунные заболевания;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">аллергические реакции;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">возрастные изменения в ухе</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">острые и хронические отиты</span></li>\r\n<li>остеохондроз шейного отдела позвоночника</li>\r\n</ul>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"pathogenesis": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В начальной стадии инфекционного поражения наблюдается преимущественно воспалительная реакция со стороны соединительной ткани, окружающей нервные волокна, возникает серозно-фибринозная экссудация. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Следующая стадия при неблагоприятном течении характеризуется распадом нервных элементов с замещением их в некоторых случаях соединительной тканью и вовлечением в дегенеративный процесс нейроэпителиальных клеток спирального органа. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При интоксикационном поражении на первый план выступают дегенеративные изменения клеток спирального органа. В частности, было показано, что ототоксические антибиотики (аминогликозиды) избирательно накапливаются в эндо- и перилимфе и кумулируются там, и в то же время они отсутствуют в остальных звеньях обоих анализаторов. Они действуют на составляющие соединительной ткани - аминогликозиканы (кислые мукополисахариды).</span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для диагностики проводится современное исследование слуха — тональная пороговая аудиометрия.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для проведения аудиометрии пациент надевает специальные наушники, в которые ему попеременно включают звуки разной частоты и громкости. В зависимости от того, слышит ли эти звуки пациент или нет, он нажимает на кнопку, а в компьютерной программе отмечаются точки на специальном графике, который и представляет из себя результат исследования — аудиограмму.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Помимо аудиометрии, в зависимости от симптомов, для установления причины потери слуха дополнительно могут быть проведены:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Отомикроскопия (осмотр уха под микроскопом);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Тимпанометрия (исследование подвижности барабанной перепонки);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Исследование вестибулярного анализатора (пробы на координацию, вращательные пробы);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консультация невролога;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Анализ показателей свертывающей системы крови;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Анализ показателей функции печени;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Компьютерная томография височных костей;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">МРТ головного мозга.</span></li>\r\n</ul>\r\n<p> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Целью всех терапевтических мер, предпринимаемых специалистами, является остановка прогрессирования заболевания, сохранение остроты слуха на текущем уровне и устранение основной симптоматики, поэтому лечение комплексное. Подразумевается медикаментозное вмешательство и физиопроцедуры. Методики подбираются согласно характеру течения болезни, степени глухоты:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">исключение громких звуков (касается разговоров, музыки, бытового шума) – для всех случаев тугоухости;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">внутривенные глюкокортикостероиды, если произошел внезапный неврит уха;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">прием антиоксидантов и инъекции улучшающих кровообращение лекарств на острой стадии болезни;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">лечение сопутствующих заболеваний (относящихся к числу факторов риска) при хронической стадии тугоухости;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">следование поддерживающей лечебной схеме каждые полгода (или чаще) для предотвращения рецидивов у больных с подострой или хронической формой.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Медикаментозное лечение</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">На раннем этапе болезни эффективность лекарственных препаратов существенно выше, чем при воздействии на запущенную тугоухость. Выбор медикаментов производится исключительно с врачом и с оглядкой на форму, которую приняло заболевание. Преимущественно назначаются такие средства:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кортикостероиды (Дексаметазон) – максимально результативны при внезапном возникновении нейросенсорного нарушения слуха, если их использовать в первые сутки. Длительность лечения – до недели, дозировки высокие, применение внутривенное.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Противовирусные средства (Ремантадин, Интерферон) – для борьбы с нарушениями слуха на фоне вирусных заболеваний.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Гистаминомиметики (Бетасерк) – назначаются при сильном головокружении.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Спазмолитические препараты (Папаверин, Дибазол) – как симптоматическое средство.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Метаболические средства (Кокарбоксилаза) – с целью стимуляции обменных процессов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Антибактериальные лекарства – если наблюдается бактериальная инфекция (присоединенная или вызвавшая основное заболевание).</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Дополнительно могут назначаться психотропные лекарственные средства, если у пациента наблюдаются нервно-психические расстройства), гипотензивные (для гипертоников). Полезны будут и усиливающие микроциркуляцию крови (Кавинтон) и витаминные препараты – на основе витаминов группы В (Нейрорубин), чтобы стимулировать восстановление нервной ткани. </span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Физиотерапевтическое лечение</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Начальная стадия нейросенсорной потери слуха поддается лечению при помощи физиопроцедур, которые останавливают патологический процесс и помогают справиться с головокружением, тошнотой, проблемами равновесия, нервно-психическими расстройствами. Физиолечение комбинируется с медикаментозной терапией, поскольку одиночно малоэффективно. Отоларингологи зачастую назначают такие процедуры:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Иглорефлексотерапия – акупунктура, воздействие тонкими иглами на особые точки, отвечающие за состояние внутренних органов и систем. Методика восточного происхождения, курс состоит из 10 сеансов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Гипербарическая оксигенация – во время процедуры больной вдыхает воздух, активно насыщенный кислородом и находящийся под высоким давлением, что улучшает кровоснабжение клеток внутреннего уха. Курс лечения тоже состоит из 10 сеансов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Магнитотерапия – местное воздействие статического магнитного поля переменных или постоянных частот, положительно влияющее на состояние сосудов, нервную систему, устраняющее боль и воспаление.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Фоноэлектрофорез – обеспечивает максимально быстрое проведение лекарств в пораженную область внутреннего уха, улучшает обменные процессы. Процедура проводится посредством наложения прокладок электродов (с лечебным веществом) на кожные покровы.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Слухопротезирование при нейросенсорной тугоухости</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если больной перестает четко различать речь и проблема постоянно прогрессирует, отоларинголог может предложить подобрать слуховой аппарат: устройство, которое фиксируется в ушной раковине и усиливает окружающие звуки. Такая методика подходит для лиц с тугоухостью по нейросенсорному типу 2 или 3 степени. Более тяжелые случаи требуют хирургической установки имплантов</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>\r\n<p> </p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Методы предупреждения данного заболевания следующие:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">регулярные обследования;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">снижение воздействия шумовых факторов;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">своевременное обращение к врачу при появлении минимальных симптомов.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Хроническая нейросенсорная потеря слуха:</span></p>\r\n<ul>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">Постепенное и медленное снижение слуха на оба уха в течение нескольких месяцев.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Ухудшается разборчивость речи: трудно различать слова в шумной обстановке.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Ухудшается восприятие высоких частот: хуже слышно звонок мобильного телефона, таймер микроволновки, писк комара, речь ребёнка, в то время как низкий мужской голос слышно лучше.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Часто сопровождается постоянным шипящим, шелестящим шумом в ушах (пациенты описывают его «как радиоприёмник», «как шум моря»).</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Острая нейросенсорная потеря слуха:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Резкая, внезапная потеря слуха.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Часто бывает только с одной стороны, сопровождается звоном в ухе, головокружением, нарушением равновесия, тошнотой.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Это всегда какая-то катастрофа в ухе: резкое нарушение кровоснабжения улитки, интоксикация, акустическая травма (после взрыва, выстрела), острое инфекционное заболевание, черепно-мозговая травма и т.п.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Острая нейросенсорная тугоухость лечится медикаментозно внутривенными вливаниями и интратимпанальным введением препаратов (в полость уха).</span></li>\r\n</ul>",
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