Audiological problems in patients with tinnitus exposed to noise and vibrations.

Tinnitus is a hearing sensation appearing without available sound fluctuations in the external environment. It is one of the major, constant and earliest symptoms suggesting different pathology of the hearing analyser. It must be considered, though, that it is evidenced also at disturbed functions of other organs and systems of the organism. The aim of the present study is to elucidate the state of the hearing analyser in patients with tinnitus occupationally exposed to noise and vibrations in relation to therapy. The study was performed on 67 miners, aged 34-55, mean age 44.5 years. The workers with subjective tinnitus (29 persons--43% of the studied group) are the object of this investigation. They were subjected to the following tests of the hearing analyser: pure tone audiometry; above-threshold audiometry (Carhardt's adaptation test, Lusher's differential threshold, SISI test, Kietz test. The evidence reveals that the studied group of workers occupationally exposed to noise, vibrations, dust, toxic substances etc. complain predominantly of tinnitus. It is accompanied by vertigo, headache and disturbed balance. Changes in the hearing function are observed; manifested by different degree of hypacusia concerning air and bone conductivity in the pure tone audiometry. The above-threshold tests also evidence deviations suggesting disturbed hearing function. These changes can be explained by mechanical-toxic pathogenic mechanisms leading to cerebral and vestibular dysfunction most probably of vascular-circulatory type manifested by the above stated deviations. The results are the basis for the following conclusions: 1. The anamnestic profile of workers with tinnitus exposed to noise and vibrations shows a prevalent percentage of vertigo, followed by headache and disturbed balance. 2. The otoneurological profile shows changes in the air and bone conductivity manifested by different degree of hypacusia. 3. The evaluation of the above-threshold tests also confirms the evidence of disturbed hearing function. 4. The relevant therapeutical approach has to be elaborated, having in mind the existing suggestion about the mechanical-toxic etiopathogenesis of the developed process of vascular-circulatory type.