Method of audiological diagnostics of perilymphatic fistulas of labyrinth in sensorineural hearing loss
SUBSTANCE: identification of sound lateralisation is performed with fork tined placed on patient's forehead centre or bridge of nose by "pinch" method. Audiometric control of patient's hearing acuity is performed with determination of initial thresholds of patient's sound perception by air conductivity on the entire tone-scale. Audiometric control of patient's hearing acuity is performed with determination of initial thresholds of patient's sound perception by bone conductivity on the entire tone-scale. After that, patient presses their head to sternum maximally tightly and keeps their head in such position for 55-65 seconds to ensure partial compression of their neck veins and to increase tension of meninges. It is accompanied by 30-50 mm of water column increase of liquor pressure. Immediately in patient determined is fact of presence or absence of change of their thresholds of sound perception by air conductivity on tone-scale at different frequencies of sounding. After that, when patient is in horizontal position on their back with their head turned on healthy ear, acoustic duct of affected ear is filled with inert liquid which has temperature equal to temperature of patient's body. Thresholds of patient's hearing are re-determined by bone conductivity. If after pressing head to sternum thresholds of patient's sound perception by air conductivity increases by 10 dB and more at not less than two different frequencies of sounding with simultaneous absence of tuning-fork lateralisation of sound into healthy ear and if threshold of sound perception by bone conductivity reduces in patient by 10 dB and more on not less than two different frequencies of sounding after filling acoustic duct of affected ear with inert liquid, presence of perilymphatic fistula of labyrinth is diagnosed in patient.
EFFECT: method makes it possible to carry out reliable diagnostics of presence of perilymphatic fistulas of labyrinth independently on mechanism of their development, and reduce diagnostics time due to complex estimation of patient's sound perception by aie and bone conductivity.
SUBSTANCE: polyharmonic audio signal of each frequency is supplied into an acoustic analyser through an ear plug hermetically jointed to a wave guide tip, the other end of which is equipped with a loud speaker connected to a generator. Three frequencies (fi), whereat a responsive component of eardrum complex impedance is equal to zero are measured. Absorption (αi) and resistance (Ri) factors are calculated for each frequency. If K>10, the eardrum state requiring no in-depth examination is stated. The polyharmonic audio signal is generated by a set of audio signals at a frequency pitch of 20 Hz and supplied in the range of 340 Hz to 3300 Hz.
EFFECT: method enables providing more reliable examination ensured by determining responsive component frequencies of the eardrum impedance and calculating the absorption and resistance factors.
SUBSTANCE: apparatus comprises an ultrasonic frequency vibration generator, a pass-band filter, an amplifier with an incremental coefficient, a power amplifier, a current sensor, a current-to-voltage transmitter, a switch unit, an amplitude current detector and an amplitude voltage detector. Besides, an electric transformer is connected to a piezoelectric transmitter; an electrode for electrophoresis is connected to a microprocessor. An increment encoder and a sensor display, a controlled current source and a polarity circuit are arranged in a control panel. The piezoelectric transmitter is arranged in a metal case; the polarity circuit has two outputs, one of which is connected to a body of the piezoelectric transmitter, while the other output is connected through an additional current sensor to the electrode for electrophoresis.
EFFECT: invention provides higher reliability of diagnosing and treating sensorineural hearing loss.
2 cl, 1 dwg
SUBSTANCE: brainstem auditory evoked responses (BAERs) to an acoustic click are recorded, and a V-peak of the evoked response is imaged. The BAERs to stimuli 40 dB are recorded. The stimuli are presented by the acoustic click and chirp-stimuli at 4,000, 1,000 and 500 Hz. If observing the V-peak in BAERs to the chirp-stimuli with the above peak absent in response to the acoustic click, a middle ear pathology is diagnosed.
EFFECT: technique enables assessing the audition function objectively accompanying the middle ear inflammations that is ensured by recording the BAER to the click and the chirp-stimuli.
SUBSTANCE: invention refers to medicine. Implementing the method involves presenting an audio signal in the form of a superposition of separate tone components of input multiple-modulated vibration generated by an overlap of several acoustic vibrations. The vibration is processed on a signal processing model in the outer, middle and inner ear. The signal processing model in the outer ear is presented by a broad-band amplifier with an average amplification frequency of 3 kHz. The signal processing model in the middle ear is presented by a parametric system, wherein one of its reactive elements changes with time synchronously with the parameter variations of the multiple-modulated vibration. The signal processing model in the inner ear is presented by a dispersive delay line, the principle of action of which is based on the elastic audio wave velocity and frequency relation.
EFFECT: invention enables providing the more accurate detection of the biophysical processes implementing the hearing mechanism of the periphery portion of the acoustic system by interpreting it into an electronic analogue.
SUBSTANCE: invention relates to medicine, namely to physiotherapy. Method includes stimulation of the area of hair sensor cells with application of sound stimulation. For this purpose frequency band corresponding to the damaged area of hair sensor cells, which has high hearing threshold, is isolated. Said band is determined as specified frequency band. Sound signal for stimulation of the damaged area of hair sensor cells is supplied. For this purpose interface of cochlea model with image of hair sensor cells, divided in accordance with resolution power of 1/k octave is used. Production of sound signal of frequency band, corresponding to selected image of the area of hair sensor cells, is carried out in case when user selects at least one image of the area of hair sensor cells. Hearing threshold is determined with application of response information in correspondence with produced sound signal. Sound signal corresponds to at least one signal, selected from group, including amplitude-modulated tone signal, frequency-modulated tone signal, pulse tone signal and amplitude-modulated narrow-band noise or combination of tone signals.
EFFECT: method increases accuracy of hearing diagnostics due to increase of resolution power of sound signals, and can be used in treatment of bradyacusia.
12 cl, 15 dwg
SUBSTANCE: following criteria are assigned with points: inflammatory process time of a first diagnosis of chronic otitis media; age of the diagnosis of chronic otitis media; degree of an auditory tube patency; degree of an auditory tube patency by tympanometry; perforation location and size; degree of ear bone and bone structure destruction; degree of tympanic mucosa thickening as a presentation of manifestation of a smoldering catarrhal inflammation - mucositis; degree of tympanic mobility in relation to the projection of annulus tympanicus; air-conduction threshold within the speech frequencies by tonal audiometry; air-bone gap within the speech frequencies by tonal audiometry; type of hearing loss by tonal and computed autiometry; degree of bacterial contamination of the tympanum and antrum; type of a tympanic discharge agent; type of micromycetes in the discharge from the tympanum and antrum; X-ray findings of a pyramid; observed symptoms of a nasal, nasopharyngeal, paranasal sinus pathologies; observed symptoms of an allergic pathology in the patient; type and extent of the previous reconstructive sanitation surgery; type and extent of the prospective reconstructive sanitation otosurgery. The derived points are summed up to state either a favourable or unfavourable prognosis of the otosurgical hearing outcome.
EFFECT: method provides the objective and integrated estimate of degree of hearing loss manifestation and prediction of developing hearing loss in chronic otitis media after the reconstructive sanitation otosurgery.
SUBSTANCE: method involves measuring the sound pressure level for each normalised octave frequency with defined maximum values of the sound pressure level for each normalised octave frequency, followed by calculation of acoustic efficiency. Measurement and determination of maximum sound pressure levels is carried out engineer workstations for which the personal protection means is designed, and acoustic efficiency is calculated based on the difference between the required and provided values of air conductivity for soundproof earphones and bone conductivity for soundproof headpieces. The obtained values are used to estimate acoustic efficiency. A higher safety factor corresponds to higher acoustic efficiency of the personal noise protection means.
EFFECT: method enables to estimate acoustic efficiency of personal noise protection means on the whole frequency range given by sanitary standards.
3 tbl, 1 ex
SUBSTANCE: invention relates to field of medicine, namely to otorhinolaryngology. Audiologic examination by method of induced otoacoustic emission at the frequency of distortion product is performed. Tonal acoustic stimuli are sent at frequencies f1, f2, satisfying condition f2/f1=1.22; f1<f2, where f2=1; 2; 4; 6 kHz, and distortion product is registered at frequency Fdp=2f1-f2. Children with gestation age less than 28 weeks are examined in 2, 3 and 6 months of life, and with gestation age more than 28 weeks in 3 and 6 months of life. Mean arithmetic value of Fdp level for all given frequencies of acoustic stimuli is determined, parameter K is calculated by formula: K=A1-A2 in dB, where: A1, A2 is mean arithmetic value of Fdp level of current and previous examination. Conclusion about retardation of auditory function maturation in children, born in gestation term less than 28 weeks, is made if K value is lower than 0.55 dB with examination between 2-3 months, and if K is lower than 1.56 dB with examination between 3-6 months, and for children, born with gestation term more than 28 weeks, with K value lower than 0.29 dB with examination between 3-6 months.
EFFECT: method makes it possible to detect possibility of bradyacusia at early stages of child's life.
2 cl, 5 tbl, 4 ex
SUBSTANCE: invention relates to field of medicine, namely to otorhinolaryngology. Harmonic signals are formed. Their level is made step-by-step by means of step-by-step controlled attenuator. Frequency of harmonic signals is measured randomly within acoustic range of perception by means of convertible generator. Patient fixes signal of quantitative value of level of perceptibility threshold by means of registration unit. For the examined person not to become accustomed to dynamics of signal increase and decrease, fixation of perceptibility threshold is performed by alternate step-by-step supply of acoustic signal by increase and decrease of its intensity, with alternation of signal intensity.
EFFECT: method makes it possible to increase reliability of signal diagnostics.
SUBSTANCE: invention relates to field of medicine, namely to otolaryngology. Indices of product of otoacoustic emission distortion are registered. If amplitude of product of otoacoustic emission distortion in low-frequency range and displacement of resonance frequency towards high-frequency range, testifying to increase of elasticity reactance, diagnosed are pathology of inner ear: chronic serous otitis medium, tympanosclerosis, adhesive otitis medium, tympanic form of otosclerosis and pathology of inner ear: Meniere's disease with increase of intralabyrinth pressure. In case of absence of reduction of amplitude of product of otoacoustic emission distortion in high-frequency range, displacement of resonance frequency towards low-frequency range, testifying to increase of viscocity reactance, chronic neurosensoric bradyacuasia is diagnosed.
EFFECT: method extends arsenal of means for differential diagnostics of pathology of middle and inner ear structures.
10 dwg, 1 ex
SUBSTANCE: clinical dental health parameters following the endodontic treatment (Cl parameter) expressed in the quantitative equivalent according to table 3, are recorded. The X-ray periapical tissue health parameters following the endodontic treatment (Rtissue parameter) expressed in the quantitative equivalent according to table 4, are recorded.The X-ray root filling health parameters following the endodontic treatment (Rfilling parameter) expressed in the quantitative equivalent according to table 5, are recorded. In questionable cases, the recording procedure involves a higher rate of the estimation scale, and for multirooted teeth - the highest rate specified; each following root filling health parameter and its assessment criterion is secondary from the previous one depending on a degree of risk of potential post-endodontic complications and arranged in the ascending order, thereby characterising an increase of a therapeutic defect rate, except for the first assessment criteria of each of the parameters of a quantitative aspect of the X-ray filling health with 1 point assigned to describe the ideal clinical outcome for the given parameter. A complex index of the endodontic treatment expressed in points is calculated by formula: CIET = Cl+Rtissue+ΣRfilling, wherein CIET is the complex index of the endodontic treatment; Cl is the quantitative characteristics of the clinical dental health following the endodontic treatment; Rtissue is the quantitative characteristics of the X-ray periapical tissue health following the endodontic treatment; ΣRfilling is a total score derived in accordance with the criteria of the quantitative characteristics of the X-ray root filling health following the endodontic treatment. The clinical outcome is analysed on a basis of theoretical evaluation of numerical ranges of accepted values of the complex index of the endodontic treatment enabling to specify the therapeutic approach to the patient. The complex index less than 12 points testifies to adequate leak resistance of the root filling; pathological changes in the periapical tissues are absent; the tooth does not need to be treated; the prediction is considered to be favourable. If the range is 13-19 points, the root filling occurs to seal the root canal inadequately; the risk of periapical complications is minimised; the 6-24-month case follow-up is recommended. The range of 20-37 points shows the unsatisfactory leak resistance of the root filling; the high probability of post-endodontic complications is stated; the recurrent endodontic manipulation is recommended; the prediction is open to question. If the index reaches 37 points and more, the surgical management is recommended.
EFFECT: by additional quantitative characteristics of the clinical and X-ray periapical tissue and root filling health, the method enables characterising the quality of the therapeutic outcomes in the nearest and remote period, and specifying the indications for a certain method of treating.
SUBSTANCE: invention refers to medicine, namely to dentistry, and can be used in diagnosing body sensitivity to dental materials. A challenge test involving a 2-hour contact of a sampling material and an oral mucosa is conducted. The state of the oral mucosa microvasculature is assessed by computed biomicroscopy. A diameter of a capillary arteriolar domain, a diameter of a capillary venular domain, a mean diameter of a capillary, a diameter of gathering venules, a functional capillary density are measured. If one of the relevant parameters tends to vary at a value, which is at least 1.5 times as much as a parameter variation error, a high sensitivity to the dental materials is diagnosed.
EFFECT: technique enables providing the more objective and reliable procedure applicable to diagnose the sensitivity by using the computed biomicroscopy for studying the tissue changes and selecting the best assessment criteria.
6 dwg, 2 tbl, 3 ex
SUBSTANCE: invention refers to medicine, namely to cardiology. A method involves estimating a compliance level on the basis of 20 test questions of the compliance rating scale applicable for the patients suffering hypertensive disease; each question has three selective answers coded from 1 to 3 points; the patient either fills in the scale independently, or ticks the answers to the questions being read out by the doctor. The result interpretation involves the total score for all the questions: 51-60 means a high compliance level; 41-50 shows a medium compliance level, whereas 40 points or less stand for a low compliance level.
EFFECT: estimating the compliance level and objectifying the results in points in the patients with hypertensive disease of the 1st-2nd stage, in arterial hypertension of the 1st-3rd degree by means of the specifically developed rating scale applicable to estimate the compliance in the patients suffering hypertensive disease.
2 tbl, 2 ex
SUBSTANCE: invention refers to medicine, functional diagnostics and can be used for preclinical, predoctoral examination, assessment of the functional state of body organs and systems, and pre-diagnosis. The method involves measuring electrical conductivity (EC) of 24 representing points of 12 symmetrical meridians, determining an arithmetic mean (AM) value of these measurements and specifying a corridor of permissible values for this patient, to which the derived values are compared in order to assess the functional state of the patient's body. That involves using the following criteria: a ratio of total ECs of Yin meridian points to total ECs of Yang meridian points, a ratio of total ECs of arm points to total ECs of leg points, a ratio of total ECs of left-side points to total ECs of right-side points. ECs are measured at voltages 5V, and/or 9V, and/or 12V. If the measurements are taken at 9V, the measured ECs are re-calculated by formula: I new=9/(29/I measured-0.1)*Coeff, (I); if the measurement process is performed at 12V, the measured values are re-calculated by formula: I new=9/(29/I measured-0.1)*Coeff, (I); and at 5V: I new=1 measured*Coeff, (III), wherein in (I), (II) and (III) respectively: I new is the re-calculated EC; I measured is the measured EC; Coeff is a correction coefficient taking into account a meridian conductivity heterogeneity. The re-calculated values are transformed into adjusted ones by formula: I adjusted=I new/I mean, wherein: I adjusted is the adjusted EC; I new is the non-adjusted re-calculated EC; I mean is the arithmetic mean value of all the 24 measurements. That is followed by delimiting an individual normal corridor for this patient depending on the preset diagnostic sensitivity S and a width of corridor of the permissible EC values Wpv. The Wpv represents a range of EC values measured in this patient, whereas the diagnostic sensitivity S is specified depending on selecting the patients with a certain disease. Delimiting the individual normal corridor for this patient is ensured by measuring intermediate coefficients for lower Kl and upper Ku corridor limits respectively: Kl=1-(1-S)*Wpv/2.1 and Ku=1+(1-Kl)*1.1. Lower L and upper U limits of the individual normal corridor are determined: L=Kl* I mean and U=Ku* I mean. That is followed by comparing I adjusted to the derived limits of the individual normal corridor.
EFFECT: method provides high accuracy of the individual diagnosis.
4 tbl, 2 ex
SUBSTANCE: senior guinea pigs are exposed to optical light generated by light emitting diodes or fluorescent tubes at a colour temperature of 4,500 K within the wavelength region of 360-460 nm for various time distances. The exposure is assessed by functional activity indices of neutrophilic granulocytes and a mononuclear cell count.
EFFECT: using the method requires no expensive equipment, critical chemicals; it is of a particular importance for evaluating the biological safety of new artificial light sources embedded into a light-colour medium; it provides expanded information on biological effects of optical light.
SUBSTANCE: method involves specifying the patient's age in years, measuring a left atrium diameter in millimetres, assessing the anti-arrhythmic therapy provided and determining a degree of aortic and mitral incompetence. The produced values are used to calculate a risk (R) of recurrent atrial fibrillation following a radiofrequency ablation procedure by original formula. If the derived value R is more than 0.5, the development of recurrent atrial fibrillation is predicted to follow the radiofrequency ablation procedure; the value R of 0.5 or less shows no risk of recurrent atrial fibrillation following the radiofrequency ablation procedure.
EFFECT: higher prediction accuracy.
SUBSTANCE: invention relates to medical equipment, namely to equipment for visualisation of physiological data. Method of monitoring physiological parameters contains stages at which physiological parameters are measured periodically or aperiodically by at least one electronic sensor, with each measured value of physiological parameter having corresponding medical expiry date, determined and continuously visualised are: the last measured value of each measured physiological parameter and its designation, medical expiry date for each measured value of physiological parameter, which represents preliminary specified maximal time, during which value of physiological parameter is visualised, remaining medical term to expiry date of each measured value of physiological parameter for inquired time moment is determined, for each measured physiological parameter with non-zero remaining time period before expiry date determined and visualised on display are: the last measured value of physiological parameter, its designation and indication of remaining medical time period before expiry date in form of indicating the number of days, hours, minutes or seconds, during which reading is visualised, or indication of amount of time before visualisation of the following reading, with removal of reading from display in real time after preliminary configured medical term before expiry date finishes, absence of image is replaced with symbol, showing absence of current reading. Method is realised with application of machine-readable carrier, containing programme, recorded on it, and device for visualisation of data values and designations of patient's physiological parameters, which contains electronic sensors for periodical of aperiodical measurement of values of physiological parameters, processor, programmed for determination of the last measured physiological parameter and display device control.
EFFECT: application of invention makes it possible to increase rapidity of determination of data remoteness of the screen.
8 cl, 13 dwg
SUBSTANCE: "orthopaedic index" is calculated as a sum of three values. The first value is derived by conducting densitometry, and points are assigned according to its findings: 1 point for norm, 2 points for osteopenia, 3 points for osteoporosis, and 4 points for severe osteoporosis. The second value is derived by means of Charlson comorbidity index; 0-2 points according to the Charlson comorbidity index scale correspond to 1 point of the second value; 3 points of the Charlson comorbidity index scale are 2 points of the second value; 4 points of the Charlson comorbidity index scale show 3 points of the second value, while 5 points and more of the Charlson comorbidity index scale correspond to 4 points of the second value. The third value is determined by assessing the quality of life as per the scales SF-36; 0-200 points according to the scales SF-36 correspond to 4 points of the third value; 201-400 points of the scale SF-36 show 3 points of the third value; 401-600 points of the scales SF-36 provide 2 points of the third value, and 601-800 points correspond to 1 point of the third value. Total score is deriving by summing up the three values to determine "the orthopaedic index": I - 1-3 points, II - 4-6 points, III - 7-9 points, IV - 10-12 points. The form of treatment is defined: the patients with index I have the endoprosthesis replacement with endoprostheses with a shortened leg of the femoral component, the greater diameter of the head (36 mm or more); the patients with index II have the endoprosthesis replacement with cementless anchored total endoprostheses; the patients with index III have the total hip replacement with cemented endoprostheses; the patients with index IV have the endoprosthesis replacement with cemented anchored bipolar endoprostheses.
EFFECT: through assessing the available factors influencing the postoperative period, prosthesis anchoring in its bed, potential endoprosthesis rejection, functional effect and potential aggravation of comorbidities, the method can improve functional outcomes, reduce the risk of endoprosthesis loosening and the risk of recurrent operations.
SUBSTANCE: invention relates to devices for medical monitoring. The method contains stages at which: a packet (7) of data about a patient is transmitted from a device (10) for patient monitoring to the central server (12); a message (72) with acknowledgement (ACK), transmitted by the central server (12) in response to receiving by the central server (10) of the transmitted packet (70) of data about the patient, with a message with acknowledgement containing a time stamp, provided from the central server (12) clock (46), indicating the time and date, when the central server (12) received the packet (70) of the patient's data; the message time stamp (72) with ACK is compared with the current time of the clock (28) of the patient monitoring device (10); and if the difference between the current time of the clock (28) of the patient monitoring device (10) and the time stamp (74) with ACK is larger than the first preliminarily determined time, the clock (28) is synchronised in accordance with the time and date in the time stamp (74) in the message (72) with ACK.
EFFECT: provision of control of the time synchronisation interface.
13 cl, 5 dwg
SUBSTANCE: non-invasive examination of vessels is performed by means of a probe, installed on the skin surface in the projection of a vessel, by a method of optic coherent (OC) tomography, tomograms, obtained without compression test and OC tomograms under conditions of the compression test by the displacement of tissues by the probe by 1 mm towards the visualised vessel, are analysed. Compressibility of the vessel, tissues and formations and uniformity of the vessel configuration change under compression are estimated on the images. If a non-uniform and/or incomplete compressibility and a non-uniformity of the vessel configuration change are detected, microangiopathy is identified.
EFFECT: method ensures the high accuracy and objectivity of non-invasive diagnostics of the condition of microvasculature, in particular, the presence of intra-vascular formations, including differential diagnostics of vasculopathy due to the identification of particular criteria for the determination of pathological changes.
5 dwg, 4 ex
SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.
EFFECT: high accuracy of diagnosis.