SENSORY DISORDERS OF THE AUDITORY AND VESTIBULAR SYSTEMS FOLLOWING BLUNT HEAD TRAUMA

摘要

It is the aim of the present review to correlate head and neck trauma and audiovestibular disorders. Acceleration/deceleration forces (during rear-end collisions of the "whiplash" type), blunt trauma of the head (without fracturing, e.g. falling from height, being hit by a solid bar) can impair the audiovestibular system at different sites. The (peripheral) auditory and vestibular receptor cells within the fluid-filled labyrinth (within the petrous bone) can transiently or permanently be impaired by mechanical dysarray or fluid concussion. Moreover, permanent lesions can arise from axonal injury of the central (integrative) parts of the auditory pathway. The major auditory complaints of the patients include an (acute) transient hearing loss and tinnitus. In a minority of patients, tinnitus, hearing loss and hyperacusis can become chronic symptoms. Most of the vertiginous complaints occur within 24 hours after the trauma (acute disorders) or after 3 weeks - 3 months (chronic disorders). The acute disorders include labyrinthine concussion, rupture of the round window membrane, cervicogenic, postural instability. The chronic disorders include otolith disorders, delayed endolymphatic hydrops, canalolithiasis. Extensive medical diagnostics is required to differentiate the type of underlying disorder. In general, there is no significant correlation between trauma mechanisms and type of audiovestibular disorder. However, acute audiovestibular disorders have a good prognosis in general, while chronic disorders have a poorer one.