medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-157medsovet-10135Research ArticleПРАКТИКАPRACTICEРетроспективный анализ данных пациентов с сенсоневральной тугоухостью в Воронежской областной клинической больницеA retrospective chart review of patients with sensorineural hearing loss in the Voronezh Regional Clinical Hospitalhttps://orcid.org/0000-0002-9734-9748НеровныйА. И.NerovnyA. I.

Неровный Александр Иванович - к.м.н., доцент, заведующий кафедрой оториноларингологии.

394036, Воронеж, ул. Студенческая, д. 10

Alexander I. Nerovny - Cand. Sci. (Med.), Associate Professor, Head of the Department of Otorhinolaryngology.

10, Studencheskaya St., Voronezh, 394036

aleksandr.nerovniy@rambler.ruhttps://orcid.org/0009-0000-6761-1680ТвилдианиТ. А.TvildianiT. A.

Твилдиани Татьяна Александровна - заведующая сурдологическим центром.

394066, Воронеж, Московский проспект, д. 151

Tatyana A. Tvildiani - Head of the Audiology Center.

151, Moskovsky Ave., Voronezh, 394066

tvildiani64@mail.ruhttps://orcid.org/0009-0005-2358-260XРябоваТ. А.RyabovaT. A.

Рябова Татьяна Александровна - врач-оториноларинголог.

394066, Воронеж, Московский проспект, д. 151

Tatyana A. Ryabova – Otorhinolaryngologist.

151, Moskovsky Ave., Voronezh, 394066

tatyana.nerovnaya@yandex.ruВоронежский государственный медицинский университет имени Н.Н. БурденкоРоссияVoronezh State Medical University named after N.N. BurdenkoRussian FederationВоронежская областная клиническая больница №1РоссияVoronezh Regional Clinical Hospital No. 1Russian Federation20260506202606176180Copyright © Неровный А.И., Твилдиани Т.А., Рябова Т.А., 20262026Неровный А.И., Твилдиани Т.А., Рябова Т.А.Nerovny A.I., Tvildiani T.A., Ryabova T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10135Введение

Введение. Данное наблюдение представляет интерес в связи с высокой распространенностью сенсоневральной тугоухости, частой поздней обращаемостью пациентов и снижением эффективности лечения при отсроченном начале терапии.

Цель

Цель. Повысить эффективность лечения острой, подострой, прогрессирующей сенсоневральной тугоухости. Оценить причины неэффективного лечения сенсоневральной тугоухости и предусмотреть варианты решения.

Материалы и методы

Материалы и методы. Проведен ретроспективный анализ данных 7 651 пациента, обратившегося к врачам-сурдологам бюджетного учреждения здравоохранения Воронежской области «Воронежская областная клиническая больница №1» (БУЗ ВО «ВОКБ №1») в 2024–2025 гг. с диагнозами H90.3 «Двусторонняя сенсоневральная тугоухость» и H90.4 «Односторонняя сенсоневральная тугоухость с нормальным слухом на противоположной стороне». Острая сенсоневральная тугоухость (СНТ) выявлена у 1 369 пациентов, подострая – у 604, прогрессирующее течение – у 513, хроническая форма – у 5 165 пациентов. У 32% пациентов с острой СНТ обращение к сурдологу произошло спустя более 25 дней от начала заболевания. Системная терапия препаратом дексаметазон проведена 1 703 пациентам в группах с острой, подострой и прогрессирующей СНТ. Оценка эффективности проводилась по динамике среднего порога слуха.

Результаты и обсуждение

Результаты и обсуждение. Улучшение слуха на 10 дБ и более отмечено у 46% пациентов с острой СНТ, у 14% пациентов с подострой СНТ и у 15% пациентов с прогрессирующим течением СНТ. Основным в лечении сенсоневральной тугоухости являются стероиды, в частности дексаметазон. Эффективность лечения зависит от раннего обращения.

Выводы

Выводы. Эффективность лечения зависит от сроков обращения. Поздняя диагностика, ошибочная первичная трактовка симптомов и отсутствие доступного самоконтроля слуха ограничивают результаты терапии. Перспективным направлением является внедрение цифровых скрининговых инструментов, что в долгосрочной перспективе снизит общие затраты и сложности, связанные с тугоухостью.

Introduction

Introduction. The presented observation is of interest due to the high prevalence of sensorineural hearing loss, frequent late presentation of patients, and reduced treatment effectiveness when therapy is delayed.

Aim

Aim. To improve the effectiveness of treatment of acute, subacute, and progressive sensorineural hearing loss. To evaluate the causes of ineffective treatment of sensorineural hearing loss and to propose possible solutions.

Materials and methods

Materials and methods. A retrospective analysis was conducted of 7 651 patients who consulted audiologists at the Budgetary Healthcare Institution of the Voronezh Region “Voronezh Regional Clinical Hospital No. 1” (BUZ VO “VOKB No. 1”) in 2024–2025, with diagnoses H90.3 “Bilateral sensorineural hearing loss” and H90.4 “Unilateral sensorineural hearing loss with normal hearing in the opposite ear”. Acute sensorineural hearing loss (SNHL) was identified in 1 369 patients, subacute in 604, progressive course in 513, and chronic form in 5 165 patients. In 32% of patients with acute SNHL, consultation with an audiologist occurred more than 25 days after disease onset.

Systemic therapy with dexamethasone (international non-proprietary name: dexamethasone; trade name, manufacturer, and country of production to be specified by the authors based on prescription records) was administered to 1 703 patients. Effectiveness was assessed by changes in the average hearing threshold.

Results and discussion

Results and discussion. Hearing improvement of 10 dB or more was observed in 46% of patients with acute SNHL, 14% with subacute SNHL, and 15% with progressive SNHL. The main treatment for sensorineural hearing loss is steroids, particularly dexamethasone. The effectiveness of treatment depends on early intervention.

Conclusions

Conclusions. Treatment effectiveness depends on the timing of presentation. Late diagnosis, incorrect initial interpretation of symptoms, and lack of accessible hearing self-monitoring limit treatment outcomes. The introduction of digital screening tools is a promising direction, which in the long term will reduce the overall costs and challenges associated with hearing loss.

ухудшение слухааудиометриясурдологиямобильные приложенияцифровые технологии в медицинеhearing lossaudiometryaudiologymobile applicationsdigital technologies in medicineReferencesChadha S, Cieza A, Krug E. Global hearing health: future directions. Bull World Health Organ. 2018;96(3):146. https://doi.org/10.2471/BLT.18.209767.Chadha S, Cieza A, Krug E. Global hearing health: future directions. Bull World Health Organ. 2018;96(3):146. https://doi.org/10.2471/BLT.18.209767.Lee J, Yoon CY, Lee J, Kong TH, Oh SH, Seo YJ. A situational analysis of ear and hearing care in South Korea using WHO Ear and Hearing Care Situation Analysis tool. Front Public Health. 2023;11:1215556. https://doi.org/10.3389/fpubh.2023.1215556.Lee J, Yoon CY, Lee J, Kong TH, Oh SH, Seo YJ. A situational analysis of ear and hearing care in South Korea using WHO Ear and Hearing Care Situation Analysis tool. Front Public Health. 2023;11:1215556. https://doi.org/10.3389/fpubh.2023.1215556.Aksoy Koçak C. Artificial intelligence and machine learning in audiology and hearing disorders: a scoping review with bibliometric and thematic mapping (1995–2025). Audiol Res. 2026;16(2):29. https://doi.org/10.3390/audiolres16020029.Aksoy Koçak C. Artificial intelligence and machine learning in audiology and hearing disorders: a scoping review with bibliometric and thematic mapping (1995–2025). Audiol Res. 2026;16(2):29. https://doi.org/10.3390/audiolres16020029.Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021. Bull World Health Organ. 2021;99(4):242–242A. https://doi.org/10.2471/BLT.21.285643.Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021. Bull World Health Organ. 2021;99(4):242–242A. https://doi.org/10.2471/BLT.21.285643.Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet. 2021;397(10278): 996–1009. https://doi.org/10.1016/S0140-6736(21)00516-X.Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet. 2021;397(10278): 996–1009. https://doi.org/10.1016/S0140-6736(21)00516-X.Singh A. Sudden sensorineural hearing loss: review. Chin Med J. 2020;133(13):1615–1622. https://doi.org/10.1097/CM9.0000000000000844.Singh A. Sudden sensorineural hearing loss: review. Chin Med J. 2020;133(13):1615–1622. https://doi.org/10.1097/CM9.0000000000000844.Кунельская НЛ, Заоева ЗО, Левина ЮВ, Никиткина ЯЮ. Слух и деменция: есть ли связь? Журнал неврологии и психиатрии им. С.С. Корсакова. 2021;121(10-2):37–40. https://doi.org/10.17116/jnevro202112110237.Kunelskaya NL, Zaoyeva ZO, Levina YuV, Nikitkina YaYu. Hearing and dementia: is there a link? Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2021;121(10-2):37–40. (In Russ.) https://doi.org/10.17116/jnevro202112110237.Mick P, Kawachi I, Lin FR. Hearing loss and social isolation. Otolaryngol Head Neck Surg. 2014;150(3):378–384. https://doi.org/10.1177/0194599813518021.Mick P, Kawachi I, Lin FR. Hearing loss and social isolation. Otolaryngol Head Neck Surg. 2014;150(3):378–384. https://doi.org/10.1177/0194599813518021.Ветрянщикова ОБ, Яковлева НС, Ильина ЛН. Нарушение слуха у лиц молодого возраста и их возможные причины. Вестник науки. 2023;4(12): 1198–1201. Режим доступа: https://www.вестник-науки.рф/article/12005.Vetrianshchikova OB, Yakovleva NS, Ilyina LN. Hearing disorders in young people and their possible causes. Vestnik Nauki. 2023;4(12):1198–1201. (In Russ.) Available at: https://www.вестник-науки.рф/article/12005.Wilson WR, Byl FM, Laird N. The efficacy of steroids in sudden hearing loss. Arch Otolaryngol. 1980;106(12):772–776. https://doi.org/10.1001/archotol.1980.00790360026004.Wilson WR, Byl FM, Laird N. The efficacy of steroids in sudden hearing loss. Arch Otolaryngol. 1980;106(12):772–776. https://doi.org/10.1001/archotol.1980.00790360026004.Wei BP, Mubiru S, O’Leary S. Steroids for sudden hearing loss. Cochrane Database Syst Rev. 2013;(7):CD003998. https://doi.org/10.1002/14651858.CD003998.pub3.Wei BP, Mubiru S, O’Leary S. Steroids for sudden hearing loss. Cochrane Database Syst Rev. 2013;(7):CD003998. https://doi.org/10.1002/14651858.CD003998.pub3.Crane RA, Camilon M, Nguyen S, Meyer TA. Steroids for sudden hearing loss. Laryngoscope. 2015;125(1):209–217. https://doi.org/10.1002/lary.24872.Crane RA, Camilon M, Nguyen S, Meyer TA. Steroids for sudden hearing loss. Laryngoscope. 2015;125(1):209–217. https://doi.org/10.1002/lary.24872.Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg. 2012;146(S3):S1–S35. https://doi.org/10.1177/0194599812436449.Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg. 2012;146(S3):S1–S35. https://doi.org/10.1177/0194599812436449.Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA et al. Clinical practice guideline: sudden hearing loss (update). Otolaryngol Head Neck Surg. 2012;146(S3):S1–S35. https://doi.org/10.1177/0194599819859885.Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA et al. Clinical practice guideline: sudden hearing loss (update). Otolaryngol Head Neck Surg. 2012;146(S3):S1–S35. https://doi.org/10.1177/0194599819859885.Conlin AE, Parnes LS. Treatment of sudden hearing loss: systematic review. Arch Otolaryngol Head Neck Surg. 2007;133(6):573–581. https://doi.org/10.1001/archotol.133.6.573.Conlin AE, Parnes LS. Treatment of sudden hearing loss: systematic review. Arch Otolaryngol Head Neck Surg. 2007;133(6):573–581. https://doi.org/10.1001/archotol.133.6.573.Yeo SW, Lee DH, Jun BC, Park SY, Park YS. Hearing outcome of sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2007;136(2):221–224. https://doi.org/10.1016/j.otohns.2006.09.012.Yeo SW, Lee DH, Jun BC, Park SY, Park YS. Hearing outcome of sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2007;136(2):221–224. https://doi.org/10.1016/j.otohns.2006.09.012.Nosrati Zarenoe R, Hultcrantz E. Corticosteroid treatment of sudden hearing loss. Otol Neurotol. 2012;33(4):523–531. https://doi.org/10.1097/MAO.0b013e31824b6b68.Nosrati Zarenoe R, Hultcrantz E. Corticosteroid treatment of sudden hearing loss. Otol Neurotol. 2012;33(4):523–531. https://doi.org/10.1097/MAO.0b013e31824b6b68.Cavaliere M, De Luca P, Scarpa A, Strzalkowski AM, Ralli M, Calvanese M et al. Hyperbaric oxygen therapy and steroids in hearing loss. Medicina. 2022;58(10):1421. https://doi.org/10.3390/medicina58101421.Cavaliere M, De Luca P, Scarpa A, Strzalkowski AM, Ralli M, Calvanese M et al. Hyperbaric oxygen therapy and steroids in hearing loss. Medicina. 2022;58(10):1421. https://doi.org/10.3390/medicina58101421.Skarżyńska MB, Kołodziejak A, Gos E, Sanfis MD, Skarżyński PH. Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss-A Retrospective Study. Life. 2022;12(1):96. https://doi.org/10.3390/life12010096.Skarżyńska MB, Kołodziejak A, Gos E, Sanfis MD, Skarżyński PH. Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss-A Retrospective Study. Life. 2022;12(1):96. https://doi.org/10.3390/life12010096.Chen WT, Lee JW, Yuan CH, Chen RF. Oral steroid treatment for sudden hearing loss. Saudi Med J. 2015;36(3):291–296. https://doi.org/10.15537/smj.2015.3.10319.Chen WT, Lee JW, Yuan CH, Chen RF. Oral steroid treatment for sudden hearing loss. Saudi Med J. 2015;36(3):291–296. https://doi.org/10.15537/smj.2015.3.10319.Бобошко МЮ, Бердникова ИП, Гарбарук ЕС, Салахбеков МА, Мальцева НВ. Влияние центральных слуховых расстройств на разборчивость речи при сенсоневральной тугоухости. Вестник оториноларингологии. 2018;83(2):4–8. https://doi.org/10.17116/otorino20188324-8.Boboshko MYu, Berdnikova IP, Garbaruk ES, Salakhbekov MA, Maltseva NV. The influence of central auditory processing on the intelligibility of the speech in the patients presenting with hearing impairment. Vestnik OtoRino-Laringologii. 2018;83(2):4–8. (In Russ.) https://doi.org/10.17116/otorino20188324-8.Гурьев АВ, Туков АР, Александрова ИВ. Производственные и медицинские аспекты профессиональной заболеваемости мужчин нейросенсорной тугоухостью. Уральский медицинский журнал. 2022;21(6):102–109. https://doi.org/10.52420/2071-5943-2022-21-6-102-109.Guryev AV, Tukov AR, Aleksandrova IV. Occupational and medical aspects of occupational morbidity in men with neurosensory hearing loss. Ural Medical Journal. 2022;21(6):102–109. (In Russ.) https://doi.org/10.52420/2071-5943-2022-21-6-102-109.Halpin C, Shi H, Reda D, Antonelli PJ, Babu S, Carey JP et al. Audiology in sudden hearing loss trial. Otol Neurotol. 2012;33(6):907–911. https://doi.org/10.1097/MAO.0b013e31825d640f.Halpin C, Shi H, Reda D, Antonelli PJ, Babu S, Carey JP et al. Audiology in sudden hearing loss trial. Otol Neurotol. 2012;33(6):907–911. https://doi.org/10.1097/MAO.0b013e31825d640f.Chen CH, Lin HH, Wang MC, Chu YC, Chang CY, Huang CY et al. Diagnostic accuracy of smartphone based audiometry for hearing loss detection: meta-analysis. JMIR Mhealth Uhealth. 2021;9(9):e28378. https://doi.org/10.2196/28378.Chen CH, Lin HH, Wang MC, Chu YC, Chang CY, Huang CY et al. Diagnostic accuracy of smartphone based audiometry for hearing loss detection: meta-analysis. JMIR Mhealth Uhealth. 2021;9(9):e28378. https://doi.org/10.2196/28378.Berampu RW, Adriztina I, Sofyan F, Machrina Y, Adenin I. Accuracy and pitfalls in smartphone based audiometry examination. Iran J Otorhinolaryngol. 2024;36(2):421–431. https://doi.org/10.22038/IJORL.2024.71187.3462.Berampu RW, Adriztina I, Sofyan F, Machrina Y, Adenin I. Accuracy and pitfalls in smartphone based audiometry examination. Iran J Otorhinolaryngol. 2024;36(2):421–431. https://doi.org/10.22038/IJORL.2024.71187.3462.Anka MH, Danjuma SA, Abdulrazak A, et al. Accuracy of smartphone hearing tests: a comparative study with traditional pure tone audiometry. Egypt J Otolaryngol. 2024;40:171. https://doi.org/10.1186/s43163-024-00733-y.Anka MH, Danjuma SA, Abdulrazak A, et al. Accuracy of smartphone hearing tests: a comparative study with traditional pure tone audiometry. Egypt J Otolaryngol. 2024;40:171. https://doi.org/10.1186/s43163-024-00733-y.Li LJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LY et al. Validation of a personalized hearing screening mobile health application. J Pers Med. 2021;11(10):1035. https://doi.org/10.3390/jpm11101035.Li LJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LY et al. Validation of a personalized hearing screening mobile health application. J Pers Med. 2021;11(10):1035. https://doi.org/10.3390/jpm11101035.Aksoy Kocak C. Artificial intelligence and machine learning in audiology and hearing disorders: a scoping review. Audiol Res. 2026;16(2):29. https://doi.org/10.3390/audiolres16020029Aksoy Kocak C. Artificial intelligence and machine learning in audiology and hearing disorders: a scoping review. Audiol Res. 2026;16(2):29. https://doi.org/10.3390/audiolres16020029

The authors declare that there are no conflicts of interest present.