The diagnosis of cervical osteochondrosis with vestibular disorders

In order to develop a unified approach to the examination of cochleovestibular disorders in patients with cervical osteochondrosis with vertebral artery syndrome, when substantiating the diagnosis, not only the nosological form of the disease should be guided, but also data on the state of auditory and vestibular functions. Although in the current collections of legislative and methodological materials for VTEC doctors there are no special sections regarding cochleovestibular disorders in patients with cervical osteochondrosis with vertebral artery syndrome, VTEC specialists must make their decision on the basis of a combination of diseases with an individual assessment of their mutual relationship and impact on the performance of that or other work, indicating the forecast. This is also due to the fact that often each syndrome of this disease does not reach the degree of severity that is taken into account during the examination. The diagnosis in such cases should be detailed and include the following data: 1) on the localization of the process in the spine (cervical, common, etc.); 2) about the main clinical syndrome (vertebral artery syndrome, radicular, cardiac, etc.); 3) the clinical phase of the disease (exacerbation, remission); 4) the state of auditory and vestibular functions. For example, such a formulation of the diagnosis is possible: 1. Cervical osteochondrosis with vertebral artery syndrome. Transient cerebrovascular accidents in the vertebrobasilar basin. Bilateral sensorineural hearing loss with persistent hearing loss in both ears until a whispering speech is heard in each ear at a distance from the auricle, stable functional compensation of vestibular function. 2. Cervical osteochondrosis with vertebral artery syndrome, radicular syndrome in the subacute stage. Right-sided sensorineural hearing loss with persistent hearing loss to perception of loud speech in the auricle, persistent and pronounced sensitivity to vestibular irritations (stage of subcompensation). Disability criteria for patients with cervical osteochondrosis with cochleovestibular disorders are based on an assessment of the set of clinical and functional characteristics that indicate the state of compensation of the vestibular and auditory analyzers (biomedical factors), and the requirements of the profession for the body (social factors). To biomedical factors include: 1) the severity of the disease; 2) the reversibility of the pathological process; 3) the degree of compensation for existing violations; a) transient cerebrovascular accident; b) pain, c) the severity of degenerative-dystrophic changes in the cervical spine; d) impaired hearing and vestibular function; 4) individual psychological characteristics; 5) the results of the examination by various specialists (neuropathologist, orthopedist, ophthalmologist, therapist). Social factors include: 1) education; 2) profession; 3) experience and experience with existing deviations in the state of health; 4) the nature, mode and conditions of work; 5) the impact of the disease on the quality of the work performed; expediency of further professional activity. It should be remembered that even the most complete treatment does not eliminate the morphological and static deformations of the spine, which led to vertebral artery syndrome with cochleovestibular disorders in patients with cervical osteochondrosis. Therefore, the prognosis of the disease in these patients should be compiled on a fairly complete objective information about the functional state of the vestibule-cochlear organ, x-ray and neurological data obtained by dynamic outpatient observation. Persons with full compensation for violations of vestibular function or with hearing loss in a state of compensation and subcompensation should be recognized as able-bodied. With decompensation of auditory impairment and the absence of impairment from the side of the vestibular analyzer, it is possible to perform labor activity with predominantly mild mental or physical stressmild or moderate voltage.

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