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Congenital syphilis is characterized by damage to the inner ear and appears at the age of 8 to 20 years. Bilateral pronounced sensorineural hearing loss develops (the Getchinson triad - deformity of incisors, parenchymal keratitis and cochlear neuritis) with a decrease, less often loss of vestibular function. Often there is a positive symptom of Anber - pressor nystagmus with a whole eardrum due to increased mobility of the stapes from syphilitic periostitis. In response to compression, a slow deviation of the eyes in the opposite direction occurs, and after the termination of compression, towards the studied ear. Deviation of the eyes is accompanied by dizziness. According to Barani, the most characteristic symptom of Anber is a tonic deviation of the eyes, and not nystagmus as with a fistula of the external semicircular canal in case of epithympanitis.
Acquired syphilis. Syphilis of the outer ear occurs in the form of chancre, secondary syphilitic rash, syphilitic (gummous) chondritis. Syphilis in the tympanic cavity almost never happens, in the mastoid process, miliary gum with giant cells is occasionally noted. In the inner ear there is a bone obliteration of the lumen of the semicircular canals, atrophy of the neuroepithelium of the cochlea and vestibular apparatus, obliterating endarteritis.
The dominant lesion in syphilis is the pathology of the inner ear. A characteristic and early sign of acquired syphilis is a pronounced shortening of bone conduction.
The defeat of the inner ear can develop slowly, accompanied by unsharp hearing loss mainly to high sounds and tinnitus. This form of hearing pathology occurs mainly in the II stage of syphilis and is prognostically favorable. In II e III noaaeyo iaae? Aaaony e auno? Ii? Ia? Anne? O? Uaa oa? Aiea, aaaouaa to severe hearing loss or deafness with a decrease or loss of vestibular function. Finally, more often in the second stage, the apoplectiform development of the disease occurs due to hemorrhage or thrombosis of the labyrinth vessels with sudden dizziness, nystagmus, tinnitus and deafness. Sudden deafness occurs after the administration of salvarsan due to toxic effects on the auditory nerve. Vestibular disorders are expressed in a decrease in excitability and dissociation between the results of rotational and caloric tests.
In spinal cord, cochleo-vestibular disorders are associated with damage to the auditory nerve, pathways and cortical centers.
The diagnosis is made on the basis of other manifestations of syphilis, history, course of the disease in combination with serological reactions. Sudden deafness with a sharp shortening or loss of bone conduction is suspicious of syphilis. In doubtful cases, the results of the trial treatment are important.
The treatment is specific.
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