RU2475223C1 - Method of treating cochleovestibular disorders in patients with cervical osteochondrosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely neurology, otorhinolaryngology and orthopaedics, and may be used for treating cochleovestibular disorders in the patients with cervical osteochondrosis. That is ensured by daily injections of the drugs improving cerebral circulation; those are followed by three-stage exposure of head-to-lower extremities centrifugal force on the patient. At the first stage, the patient is exposed to one session a day of centrifugal force at 28 rpm for 5 minutes. The second stage involves 3 days of the exposure to centrifugal force at 30 rpm for 8 minutes, one session a day. The third stage involves 4 days of the daily exposure to centrifugal force at 30 rpm for 10 minutes.

EFFECT: implementing the method provides the higher therapeutic effect ensured by the traction exposure on the cervical spine, passive training of vestibular analyser stability, improved vertebrobasilar circulation ensured by vertebral artery spasmolysis under craniocaudal hypergravitation.

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Description

The invention relates to medicine, specifically to methods for treating cochleo-vestibular disorders in patients with osteochondrosis of the cervical spine.

There is a method of treating cochleo-vestibular disorders using a climatic recovery chamber equipped with radiation sources, air supply and removal, and air conditioning (1).

The disadvantage of this method is the increased complexity of the design of the camera, the long term of treatment of the patient and significant material costs.

A known method of treating cochleo-vestibular disorders using an oxygen baromagnetotherapy chamber equipped with a source of magnetic and ultraviolet radiation (2).

The disadvantage of this method is the long duration of treatment and the possibility of relapse of the disease.

A known method of treating cochleo-vestibular disorders using a device for oxygen-helium therapy containing a tent with gas supply and removal elements (3).

The disadvantage is the low effectiveness of the treatment and the high cost of treatment.

A known method of treating cochleo-vestibular disorders by training the muscles of the cervical spine by a series of static exercises for the muscles of the neck (4, 5).

The disadvantage of this method is the low efficiency, long duration of treatment and the possibility of relapse of cochleo-vestibular disorders.

A known method of treating cochleo-vestibular disorders using a steam chamber (6, 7).

The disadvantage of this method is the lack of effectiveness and a short period of remission.

There is a method of treating cochleo-vestibular disorders by injection of vasoactive drugs (8).

The disadvantage of this method is the low effectiveness of the therapeutic effect, as well as the fact that it does not provide a long-term remission of the disease.

The aim of the invention is to increase the effectiveness of the treatment of cochleo-vestibular disorders in patients with osteochondrosis of the cervical spine.

This goal is achieved by the fact that after daily injections of drugs, the patient is exposed to centrifugal forces in the direction of the head - lower limbs in three stages:

- at the first stage, for 3 days, one session is carried out every day by centrifugal forces for 5 minutes at a rotation speed of 28 rpm;

- at the second stage, for 3 days, one session is carried out every day by centrifugal forces for 8 minutes at a speed of 30 rpm;

- at the third stage, for 4 days, one session is carried out every day by centrifugal forces for 10 minutes at a rotation speed of 30 rpm.

The method is implemented as follows. Treatment is carried out in 3 stages. In this case, the patient is located on the installation bed with his head in the center of rotation and with his feet touching the pedals. The patient's body is fixed with straps. During a session of exposure to centrifugal forces, the patient makes constant foot movements on the pedal simulator.

The first stage takes 3 days with daily injections of drugs.

On the first day, the patient is injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, intranasal blockade is performed in the posterior ends of the lower nasal turbinates with 2% novocaine solution; after injections, the patient is placed on a stand and subjected to centrifugal forces in the direction of the head - lower limbs for 5 minutes at a rotation speed of 28 rpm.

On the second day, the patient is injected with a 2% solution of pentoxifylline 5 ml per 200 ml of a 0.9% solution of sodium chloride intravenously, a 20% solution of piracetam 10 ml intravenously, a metatympanal blockade with a 1% solution of novocaine; after injections, the patient is placed on a stand and gravity therapy is carried out for 5 minutes at a rotation speed of 28 rpm.

On the third day, the patient is injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal blockade is performed at the posterior ends of the lower nasal concha; after injections, the patient is placed on a stand and subjected to centrifugal forces for 5 minutes at a rotation speed of 28 rpm.

The second stage takes 3 days, during which the patient is injected daily with drugs.

On the first day, a 2% solution of pentoxifylline is introduced in a dose of 5 ml per 200 ml of a 0.9% solution of sodium chloride intravenously, 20% solution of piracetam in 10 ml intravenously, a metatympanal blockade is performed with a 1% solution of novocaine; after injections, the patient is placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

On the second day, the patient is given 5 ml Cavinton intravenously in 200 ml of 0.9% sodium chloride solution, 20% Piracetam solution in 10 ml intravenously, intranasal blockade in the posterior ends of the lower nasal concha; after injections, the patient is placed on a stand and gravity therapy is carried out for 8 minutes at a rotation speed of 30 rpm.

On the third day, the patient is injected with a 2% solution of pentoxifylline 5 ml per 200 ml of a 0.9% solution of sodium chloride intravenously, 20% solution of piracetam 10 ml intravenously, perform metatympanal blockade with a 1% solution of novocaine; after injections, the patient is placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

The third stage takes place within 4 days.

On the first day, the patient is injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, intranasal blockade is performed in the posterior ends of the lower nasal turbinates with 2% novocaine solution; after injections, the patient is placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the second day, the patient is injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% solution of piracetam 10 ml intravenously, perform metatympanal blockade with 1% novocaine solution; after injections, the patient is placed on a stand and gravity therapy is carried out for 10 minutes at a rotation speed of 30 rpm.

On the third day, the patient is injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal blockade is performed in the posterior ends of the lower nasal concha with 2% novocaine solution; after injections, the patient is placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the fourth day, the patient is injected with a 2% solution of pentoxifylline 5 ml per 200 ml of a 0.9% solution of sodium chloride intravenously, 20% solution of piracetam 10 ml intravenously, perform metatympanal blockade with a 1% solution of novocaine; after injections, the patient is placed on a stand and gravity therapy is carried out for 10 minutes at a rotation speed of 30 rpm.

The invention is illustrated by graphic material, which shows a device with which the patient is exposed to centrifugal forces in the direction of the head - lower limbs. The device includes a platform 1, an engine 2 on the base 3. On the platform 1 is a matrix 4 for the patient 5, a headrest 6 and an emphasis for legs 7.

CLINICAL EXAMPLES

Example 1

Patient M., 53 years old, a programmer, was admitted to the hospital with complaints of hearing loss in both ears, loud tinnitus, dizziness in the form of instability, swaying of objects, headache in the occipital region. Sick for 5 years, when the above complaints first appeared. In ENT status: nose, pharynx, larynx, ears - without deviations from the norm. The auditory function is impaired: a whisper perceives from a distance of 4 m in both ears, talking from a distance of more than 6 meters. Identified spontaneous horizontal rotator nystagmus I degree to the left. Hands in the pose of Vodak-Fisher leaned to the right. Optokinetic nystagmus is not impaired. In the Romberg position and when walking - a sharp sway to the right. With bithermal caloric and rotational tests, bilateral caloric areflexia and severe hyporeflexia of post-rotational nystagmus are detected. Radiography of the cervical spine shows signs of osteochondrosis of the cervical spine. According to ultrasound dopplerographic examination of the vessels of the neck - signs of extravasal effects on the vertebral arteries. Diagnosed with Bilateral vestibulo-cochlear neuritis of vascular origin. Osteochondrosis of the cervical spine. The patient underwent the following treatment: 5 ml Cavinton intravenously in 200 ml of 0.9% sodium chloride solution, every other day, alternating with 2% pentoxifylline solution in 5 ml per 200 ml of 0.9% sodium chloride solution, 20% solution 10 ml of piracetam intravenously daily, intranasal blockade to the posterior ends of the lower nasal turbinates with 2% novocaine solution every other day alternating with metatympanal blockade with 1% novocaine solution. By the 10th day of treatment, the patient noted a slight decrease in tinnitus and a decrease in dizziness. The severity of hearing has not changed. According to vestibulometry data, the following results were obtained: spontaneous nystagmus was not detected, hands did not deviate in the Vodak-Fischer test, deviation to the right was noted in the Romberg position. The patient was examined after 3 months. According to her, tinnitus resumed with the same strength 2-3 weeks after discharge from the hospital, it remains to this day, dizziness is present, although its intensity is lower. In general, the patient evaluates the treatment results as unsatisfactory. On examination, revealed spontaneous vestibular disorders in the form of spontaneous nystagmus to the left, a deviation in the Romberg position to the right. With load-bearing bithermal caloric samples, bilateral areflexion of nystagmal reactions was noted, with a rotational test, bilateral hyporeflexion. A second course of treatment using gravity therapy was recommended. The treatment was carried out in 3 stages. The first stage took 3 days with daily injections of drugs. On the first day, the patient was injected with 5 ml Cavinton intravenously in 200 ml of 0.9% sodium chloride solution, 20% Piracetam solution in 10 ml intravenously, intra-nasal blockade was performed in the posterior ends of the lower nasal turbinates with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces in the direction of the head - lower extremities for 5 minutes at a rotation speed of 28 rpm.

On the second day, the patient was injected with 2% pentoxifylline solution of 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution of 10 ml intravenously, metatympanal blockade with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 5 minutes at a rotation speed of 28 rpm.

On the third day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal block was performed in the posterior ends of the lower nasal concha; after injections, the patient was placed on a stand and subjected to centrifugal forces for 5 minutes at a rotation speed of 28 rpm.

The second stage took 3 days, during which the patient was injected daily with drugs.

On the first day, a 2% solution of pentoxifylline was introduced in a dose of 5 ml per 200 ml of a 0.9% sodium chloride solution intravenously dropwise, in a 20% solution of piracetam 10 ml in an intravenous stream, a metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

On the second day, the patient was given 5 ml Cavinton intravenously in 200 ml of 0.9% sodium chloride solution, 20% Piracetam solution in 10 ml intravenously, intranasal blockade in the posterior ends of the lower nasal concha; after injections, the patient was placed on a stand and gravity therapy was carried out for 8 minutes at a rotation speed of 30 rpm

On the third day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution 10 ml intravenously, metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

The third stage took 4 days.

On the first day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, intra-nasal blockade was performed in the posterior ends of the lower nasal turbinates with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the second day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution 10 ml intravenously, metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 10 minutes at a rotation speed of 30 rpm.

On the third day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, intra-nasal blockade was performed in the posterior ends of the lower nasal turbinates with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the fourth day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution 10 ml intravenously, metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 10 minutes at a rotation speed of 30 rpm.

The patient on the 5th day of treatment noted a significant decrease in tinnitus, and by the end of treatment, tinnitus ceased, dizziness did not bother. Hearing acuity has not changed, however, the patient notes a subjective improvement in hearing due to the absence of tinnitus. According to vestibulometry data, the following results were obtained: spontaneous nystagmus was not detected, hands did not deviate in the Vodak-Fischer test, slight swaying in different directions was noted in the Romberg position. The patient was examined after 3 and 6 months - tinnitus did not disturb, there was no dizziness. Spontaneous vestibular disorders are not marked. A course of treatment with the use of gravity therapy sessions 2 times a year was recommended. In the process of dynamic observation for 2 years, the patient has no complaints.

Example 2

Patient K., 49 years old, an engineer, was admitted to the hospital with complaints of loud tinnitus, dizziness, hearing loss in both ears. Sick for 8 years, when the above complaints first appeared. In ENT status: nose, pharynx, larynx, ears - without deviations from the norm. Hearing acuity is not impaired: a whisper perceives from a distance of 6 m in both ears, a conversation from a distance of more than 6 meters, and according to tonal threshold audiometry - an increase in thresholds of tone perception in bone and air conduction by 4 and 8 thousand Hz by 30 dB. Spontaneous vestibular disorders were not detected. Optokinetic nystagmus is not impaired. In the Romberg position and when walking - deviation in different directions. With bithermal caloric and rotational tests, bilateral caloric areflexion and hyporeflexia of rotational nystagmus are detected. Radiography of the cervical spine shows signs of osteochondrosis of the cervical spine. According to ultrasound dopplerographic examination of the vessels of the neck - signs of extravasal effects on the vertebral arteries. Diagnosed with Bilateral cochleo-vestibular dysfunction of vascular origin. Osteochondrosis of the cervical spine. A course of treatment was carried out using gravitational therapy. The treatment was carried out in 3 stages. The first stage took 3 days with daily injections of drugs. On the first day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal blockade was performed in the posterior ends of the lower nasal concha with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces in the head - lower limbs direction for 5 minutes at a rotation speed of 28 rpm.

On the second day, the patient was injected with 2% pentoxifylline solution in 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution in 10 ml intravenously, metatympanal blockade with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 5 minutes at a rotation speed of 28 rpm.

On the third day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal block was performed in the posterior ends of the lower nasal concha; after injections, the patient was placed on a stand and subjected to centrifugal forces for 5 minutes at a rotation speed of 28 rpm.

The second stage took 3 days, during which the patient was injected daily with drugs.

On the first day, a 2% solution of pentoxifylline was introduced in a dose of 5 ml per 200 ml of a 0.9% sodium chloride solution intravenously dropwise, in a 20% solution of piracetam 10 ml in an intravenous stream, a metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

On the second day, the patient was given 5 ml Cavinton intravenously in 200 ml of 0.9% sodium chloride solution, 20% Piracetam solution in 10 ml intravenously, intranasal blockade in the posterior ends of the lower nasal concha; after injections, the patient was placed on a stand and gravity therapy was performed for 8 minutes at a rotation speed of 30 rpm.

On the third day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of a 0.9% sodium chloride solution intravenously dropwise, a 20% solution of piracetam 10 ml intravenously by injection, a metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 8 minutes at a rotation speed of 30 rpm

The third stage took 4 days.

On the first day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal block was performed in the posterior ends of the lower nasal concha with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the second day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution 10 ml intravenously, metatympanal blockade was performed with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 10 minutes at a rotation speed of 30 rpm.

On the third day, the patient was injected with Cavinton 5 ml intravenously in 200 ml of a 0.9% sodium chloride solution, 20% piracetam solution in 10 ml intravenously, an intranasal blockade was performed in the posterior ends of the lower nasal concha with 2% novocaine solution; after injections, the patient was placed on a stand and subjected to centrifugal forces for 10 minutes at a rotation speed of 30 rpm

On the fourth day, the patient was injected with a 2% solution of pentoxifylline 5 ml per 200 ml of 0.9% sodium chloride solution intravenously, 20% piracetam solution 10 ml intravenously, metatympanal blockade with 1% novocaine solution; after injections, the patient was placed on a stand and gravity therapy was carried out for 10 minutes at a rotation speed of 30 rpm.

The patient on the 4th day of treatment noted a significant decrease in tinnitus, and by the end of treatment, tinnitus ceased, dizziness did not bother. According to the tonal threshold audiometry, a decrease in the thresholds of perception of pure tones by 4 and 8 thousand Hz by 20 dB was noted, thus, hearing improvement occurred by 10 dB. According to vestibulometry, the following results were obtained: spontaneous vestibular disorders were not detected, it is stable in the Romberg position. The patient was examined in dynamics after 3 and 6 months - tinnitus did not disturb, there was no dizziness. Spontaneous vestibular disorders are not marked. In the process of dynamic observation for 3 years, the patient has no complaints.

Using the proposed method allows to reduce the manifestation of cochleo-vestibular disorders in patients with pathology of the vertebral arteries due to osteochondrosis of the cervical spine. This is achieved by improving blood circulation in the vertebral-basilar system, since craniocaudal hypergravity has a inhibitory effect on the sympathetic nervous system (9), and therefore, the spasm of the vertebral arteries that occurs when osteophytes mechanically stimulate the sympathetic periarterial plexus; has a traction effect on the cervical spine (10); carries out passive training of the stability of the vestibular analyzer (11).

Comparison of the proposed method with others known in the field of medicine, showed its compliance with the criteria of the invention.

The method is intended for the treatment of cochleo-vestibular disorders in patients with impaired blood flow through the vertebral arteries caused by osteochondrosis of the cervical spine and can be used in departments of the otorhinolaryngological, orthopedic and neurological profiles.

INFORMATION SOURCES

1. USSR copyright certificate No. 1114426, Cl. A61M 16/02, 1984.

2. Copyright certificate of the USSR No. 1123711, Cl. A61M 16/02, 1984.

3. Copyright certificate of the USSR No. 1047479, Cl. A61H 17/00, 1989.

4. Yumashev G.S. and other "Osteochondrosis of the spine", M., Medicine, 1973, S. 97-96.

5. Copyright certificate of the USSR No. 797684, Cl. A61F 5/04, 1981.

6. Copyright certificate of the USSR No. 1273106, Cl. A61H 33/06, 1986.

7. US Patent No. 3945058, Cl. A61H 33/06, 1976.

8. Guide to otorhinolaryngology. / Ed. I. B. Soldatova. - M.: Medicine, 1997 .-- 608 p.

9. Pashchenko P.S., Sukhoterin A.F. The state of the sympathetic and parasympathetic centers of the brain and spinal cord of rats under the influence of overloads + Gz. // Aerospace and environmental medicine. - 2007. - No. 2. - S. 45-49.

10. Mikhaylina E.S. Gravity therapy in the complex treatment of lumbar osteochondrosis: author. dis. Cand. honey. sciences. Samara, 2009.22 p.

11. Vladimirova T.Yu. The role of the motor factor in improving the quality of life of patients with vestibular dysfunction of varying severity. // Russian otorhinolaryngology. - 2009. - Appendix No. 2. S.17-21.

Claims (1)

A method of treating cochleo-vestibular disorders caused by osteochondrosis of the cervical spine by injecting a patient with drugs that improve blood circulation in the brain, characterized in that after daily injections of drugs, the patient is exposed to centrifugal forces in the head-lower limbs direction in three stages:
at the first stage, for 3 days, one session is carried out every day by centrifugal forces for 5 minutes at a rotation speed of 28 rpm;
at the second stage, for 3 days, one session is carried out every day by centrifugal forces for 8 minutes at a speed of 30 rpm;
in the third stage, for 4 days, one session is carried out every day by centrifugal forces for 10 minutes at a rotation speed of 30 rpm.