Auditory rehabilitation in head-injured patients

25 patients (32 ears) were examined to evaluate the effectiveness of auditory rehabilitation after ear surgery. Patients of experimental group with head injury in the past (12 cases) received comprehensive auditory rehabilitation including auditory training combined with non-invasive neuromodulation by electrotactile stimulation on the tongue. Control group consisted of 20 patients after ear surgery without any treatment. Pure tone audiometry and speech-in-noise auditory tests with signal-noise ratio of 0 dB were used. Rehabilitation began 1 month after surgery. Auditory training represented a listening to audio scripts which contained speech fragments. Non-invasive neuromodulation was performed via electrotactile stimulation on the tongue with BrainPort device. Rehabilitation was performed twice a day for 20 min over 10 days. Hearing levels were estimated before surgery, and 1, 3 and 12 months after surgery. There was a hearing gain in majority of patients from both groups 1 month after surgery due to improved air conduction (p < 0.01). After auditory rehabilitation, pure tone levels did not change in both groups (p > 0.05), and word recognition improved in 11 patients (91.7 %) from experimental group (p < 0.01) compared to no changes in control group (p > 0.05). Three months after ear surgery there was hearing gain of pure tone levels in all tests both via air and bone in patients from both groups (p < 0.05). Word recognition also improved p < 0.01). Hearing level didn’t change significantly after 12 months from ear surgery compared to 3-month levels. So, we concluded that sensory component of hearing loss due to central disturbances in auditory system after head trauma is reversible and can be improved by ear surgery and rehabilitation procedures. The proposed method of combined auditory rehabilitation improves the effectiveness of treatment in case of head injuries combined with ear trauma.

черепно-мозговая травма, тугоухость, тимпанопластика, речевая аудиометрия, нейропластичность, слуховая система, неинвазивная нейромодуляция, head trauma, hearing loss, tympanoplasty, speech audiometry, neural plasticity, auditory system, non-invasive neuromodulation

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