CONVENTIONAL AND EXTENDED HIGH-FREQUENCY AUDIOMETRY FINDINGS IN POST-COVID-19 PATIENTS WITH SENSORY DISORDERS
DOI:
https://doi.org/10.37219/c3jcn426Keywords:
COVID-19, sensorineural hearing loss, conventional audiometry, extended high-frequency range, Lüscher test, sensory disordersAbstract
Abstract
Background. Coronavirus disease (COVID-19) is a multisystem pathology that frequently causes damage to the nervous system and sensory organs. The features of post-COVID cochlear dysfunction in the extended high-frequency spectrum remain insufficiently studied.
Objective. To evaluate the state of auditory function based on conventional and extended high-frequency audiometry data in patients with post-COVID sensory disorders of various severity.
Materials and Methods. A total of 120 patients with post-COVID sensory disorders (impairments of hearing, smell, taste, voice, and neurological symptoms) were examined. Depending on the disease course, patients were divided into two groups: Group 1 (n = 74) included individuals with moderate and mild hearing loss; Group 2 (n = 46) consisted of patients after severe COVID-19 with persistent hearing disorders. The control group comprised 15 healthy individuals with no history of COVID-19 and no hearing complaints. Auditory function was assessed using a clinical audiometer AC-40 (Interacoustics, Denmark) in conventional (0.125–8 kHz) and extended (9–16 kHz) frequency ranges. Speech audiometry and the Lüscher test were also performed. Statistical analysis was carried out using Student's t-test.
Results. In patients of both groups, a predominantly sensorineural pattern of lesion with a downward configuration of the audiometric curve was verified. Mean hearing thresholds in the conventional range were statistically significantly higher compared to the control group at frequencies of 3–8 kHz (p < 0.01). In the extended range (9–14 kHz), a pronounced destructive increase in thresholds was revealed, peaking at 12 and 14 kHz (74.50 ± 1.69) dB in Group 1 and 81.50 ± 2.84 dB in Group 2; (p < 0.01). At a frequency of 16 kHz, some patients did not perceive the signal due to the technical limit of the device (60 dB). The Lüscher test revealed a decrease in differential thresholds in Group 2, indicating the presence of a positive recruitment phenomenon. Post-COVID progression of pre-existing hearing loss was recorded in 25.6% of Group 1 and 60.8% of Group 2 patients. Severe hearing deficit was more frequently combined with damage to other sensory systems (olfactory, gustatory, vestibular) and central neurological symptoms.
Conclusions. Sensorineural hearing disorders after COVID-19 can manifest for the first time (especially in severe cases) or be caused by the progression of pre-existing hearing loss. Extended high-frequency audiometry (9–16 kHz) is a highly sensitive method capable of detecting early subclinical changes in auditory sensitivity.
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