HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS. / GIRUDOTERAPIIa PRY PRESBYACUZIS PRAECOX V UChASNYKIV LIKVIDATsIÏ NASLIDKIV AVARIÏ NA ChORNOBYL'S'KIY̆ ATOMNIY̆ ELEKTROSTANTsIÏ U PISLIaAVARIY̆NYKh ROKAKh.

OBJECTIVE: to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years. MATERIALS AND METHODS: From archive data of previously examined 8,136 males' CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosime- try data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclu- sion zone from the end of 1986 to 1992-1994 amounted to 0.21-0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients' auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40-49 and 50-59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used. RESULTS: Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in pres- byacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6-9 months comparing to 12-18 months of hiruditherapy one, being twice longer. Improving the patients' coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox. CONCLUSIONS: It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopa- totherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clini- cal practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality.

[Cerebral circulation in the patients presenting with the early disorders of the sound perception function].

The present paper is focused on the study of the auditory function and cerebral circulation estimated based on the results of rheoencephalographc examination of 75 patients presenting with disordered sound perception and divided into two groups. Group 1 was comprised of the patients complaining of impaired hearing of the tones only within the extended frequency range (9-16 kHz), group 2 consisted of the patients suffering impaired hearing in the conventional frequency range (0.125-8 kHz). It was shown that the brainstem structures of the auditory analyzer in the patients of both groups remained unaffected whereas the cortical structures thereof in the patients of group 2 exhibited the signs of dysfunction. Cerebral circulation was disturbed in both groups, but its changes were especially well pronounced in the patients of group 2. These findings are of interest in the context of diagnostics and treatment of the patients presenting with early disorders of the sound perception function.

[Acoustic evoked potentials in patients with vocal problems in relation to their hearing in wide frequency range]. / Slukhovye vyzvannye potentsialy u bol'nykh s narusheniiami golosa v zavisimosti ot sostoianiia slukha v rashirennom diapazone chastot.

The function of different compartments of the acoustic analyser was assessed by the findings at tonal audiometry in standard and extended range of frequencies (10, 12, 14 and 16 kHz) as well as by characteristics of acoustic evoked potentials. A total of 62 patients with chronic vocal dysfunction (CVD) and 20 subjects with normal hearing and voice were examined. CVD patients were found to have: normal hearing both in standard and extended range of frequencies (25.8%); normal hearing in standard but defective one in extended range of frequencies (51.6%); defective hearing sensitivity to tones both in standard (4, 6 and 8 kHz) and extended frequency range (22.58%). CVD patients with abnormal hearing in the extended frequency range exhibited affection of the brain stem and cortical compartments of the acoustic analyser. Acoustic evoked potentials were especially abnormal in patients with high hearing thresholds (17.4 +/- 1.6; 25.8 +/- 1.9, 29.7 +/- 2.1 dB) in standard frequency range (4, 6 and 8 kHz), respectively. In such patients the disease ran a protracted course with frequent relapses. These findings can help in making decision on the treatment policy, occupational fitness expertise and selection of patients with vocal professions.