SUDDEN SENSORINEURAL HEARING LOSS AND ITS ASSOCIATION WITH PATENT FORAMEN OVALE IN SCUBA DIVERS

Introduction. Sudden sensorineural hearing loss (SSNHL) is a condition typically characterized by unilateral hearing impairment, with a decrease of at least 30 dB across three or more adjacent frequencies. Patent foramen ovale (PFO) is a common finding in the general population. Under increased hydrostatic pressure, this condition may contribute to sudden hearing loss in divers. Aim. The aim of this study is to investigate the impact of patent foramen ovale on the development of hearing disorders in individuals engaged in diving activities. Materials and methods. The main study group consisted of 59 certified divers, while the control group included 20 healthy volunteers who had never engaged in scuba diving. Inclusion criteria for the main study group were: age between 18 and 55 years and professional certification. Exclusion criteria were: pregnancy; alcohol or drug addiction; psychiatric disorders in the medical history; documented acoustic or barotrauma of the ear; acute inflammatory diseases of the upper respiratory tract, including middle ear pathology at the time of examination. All participants in both groups underwent medical history collection and ear, nose, and throat (ENT) examination, acoustic impedance audiometry, otoacoustic emission testing at distortion product frequencies, and heart ultrasound (echocardiography). Results. The results of otoacoustic emission testing in the diver group exhibited significant deviations from the normal range in the low-frequency domain, with values notably lower than 6 dB. This suggests a potential impact of diving on the early changes in the function of outer hair cells. The presumed pathophysiological mechanism for hearing loss in divers is paradoxical embolism. We hypothesize that in these patients, microembolic processes may lead to ischemic changes, contributing to peripheral auditory system dysfunction. Conclusions. The findings indicate that the presence of patent foramen ovale in divers may be a contributing factor to the development of sensorineural hearing loss. Further studies are needed to better understand the potential risks and mechanisms involved in diving-related auditory disturbances.