T. A. Shydlovska^1, N. M. Voroshylova¹, Yu. B. Burlaka¹,
D. S. Korolova², Yu. D. Vinnichuk²*, D. M. Kuleshova¹,
V. O. Kotov¹, S. V. Verevka¹

¹SI “Prof. O.S. Kolomiichenko Institute of Otolaryngology
of the National Academy of Medical Sciences of Ukraine”, Kyiv;
²Palladin Institrute of Biochemistry, National Academy of Sciences of Ukraine, Kyiv;
*e-mail: vinnichukju@gmail.com

Received: 03 June 2025; Revised: 17 September 2025;
Accepted: 28 November 2025; Available on-line:     2025

The problem of early diagnosis and treatment of acute traumatic injury and its complications has been sharply actualized in today’s circumstances of combat actions. Аcubarotrauma (ABT) is a specific dama­ge characterized by manifestations from the side of the auditory system and those not related directly to the structures of the auditory system, such as severe forms of sensorineural deafness (SND). The development of SND can be associated with vascular pathology, hydrodynamic impact on blood vessels, damage to the vascular endothelium and uncontrolled release of various clotting factors into the bloodstream. The purpose of this work was to estimate the state of the hemostasis system in patients who received ABT injuries in combat zone and have sensorineural hearing disorders. The following parameters in the patient’s blood plasma were measured: fibrinogen concentration, activated partial thromboplastin time (APTT), prothrombin time (PT), functionally inactive forms of prothrombin (FIFP), ecamulin time, the levels of protein C (PC), soluble fibrin-monomer complexes (SFMCs), soluble fibrin (SF) and D-dimer. The control group was formed by 15 healthy persons with normal hearing. 94 patients with combat ABT injuries were divided into 4 groups according to the severity of hearing impairment and the period after getting ABT: 1, 2 – patients with a mild hearing impairment, who contacted a medical facility within 2 months or more than 2 months after the injury respectively; 3, 4 – patients with a more severe hearing impairment who contacted a medical facility within 2 months or more than 2 months after the injury, respectively. Patients of all groups had significantly prolonged APT and increased SF, SFMCs and prethrombin-1 levels in the blood plasma compared to the control parameters. In patients of the 4^th group, a PT prolongation was noted. The protein C level in the 1^st, 2^nd, and 3^rd groups showed a tendency to decrease and was statistically reduced compared to the control in the 4^th group. Concentration of D-dimer decreased in patients of the 1^st and 2^nd groups, remained at the control level in the 3^rd, and increased in the 4^th group. The fibrinogen level and ecamulin time ET in all studied groups remained at the level of control values. The observed dysfunctions of the hemostasis system links in patients with combat ABT indicate a slow development of disseminated intravascular coagulation syndrome. That is why patients with a severe hearing impairment due to combat ABT, regardless of the period of seeking medical help, need examinations after the injury according to a special algorithm of laboratory signs.