[Neurosensory deafness: immunological aspects]

Seven hundred and twelve patients with first diagnosed pulmonary tuberculosis were examined; neurosensory hypoacusis was detected in 12.2% of the cases. The above patients underwent neurological, otolaryngological, and immunological studies. Second- and third-degree hypoacusis was found in 13.7 and 86.3%, respectively. Neurological syndromes were identified. These included vegetovascular dystonia in 50.5% of the patients, multiple cerebral minor symptoms in 45.5%, focal cerebral lesion in 4%/Comparison of the severity of nerve system disease and the level of hypoacusis has indicated that the more severe neurological disorders, neurosensory hypoacusis becomes more aggravated (K = 0.57). Positive skin Mantoux tests in all patients with neurosensory hypoacusis showed their allergization to Mycobacterium tuberculosis. In the examined patients, specific basophilic deformability (SBD) rates in the tuberculin test were 17.5 +/- 1.3% g, which differed significantly (p < 0.001) from those in the controls (5.1 +/- 0.9%). In second-degree neurosensory hypoacusis, SBD rates were significantly higher than those in first-degree one, which suggests that the allergic factor contributes to the development of neurosensory hypoacusis in the presence of tuberculosis. The values of antibodies to myeloperoxidase (1.869 +/- 0.02 optical density units (ODU) and to IgE (416.386 +/- 0.391 I.U./ml) significantly differed from those in the control group (0.08 +/- 0.02 ODU and 96.667 +/- 0.441 I.U./ml, respectively), which is indicative of primary lesions of minute blood vessels as the type of vasculitis and secondary nervous tissue involvement. Thus, allergic, vascular, and immune mechanisms are the main pathophysiological ones of neurosensory hypoacusis in the presence of first diagnosed and untreated tuberculosis.