Innenohrschwerhörigkeit Teil II: Plötzliche Hörminderung (Hörsturz) – Therapeutische Optionen

Zusammenfasssung

Der überaus größte Anteil von Hörstörungen beruht auf Schädigungen des Innenohres, in aller Regel Schäden der äußeren Haarzellen, die durch verschiedene Ursachen entstehen können, wie im ersten Teil dieser Übersicht dargelegt worden ist. Häufig treten jedoch Hörminderungen plötzlich, als „Hörsturz“ auf. Sie sind dann zumeist einseitig, bessern sich oft spontan und sollten therapeutisch angegangen werden, da im Akutstadium durchaus medikamentöse therapeutische Optionen bestehen. Dagegen sind chronische Innenohrschwerhörigkeiten nicht kurativ zu behandeln, eine wirksame Therapie der länger bestehenden Innenohrschwerhörigkeit ist nach wie vor nur rehabilitativ möglich, da bei allen Säugetieren und damit auch dem Menschen die Strukturen des Innenohres insgesamt, insbesondere die Haarzellen, nicht regenerationsfähig sind. Medikamente oder andere Verfahren zur Regeneration defekter Haarzellen sind nicht verfügbar, eine potentielle Gentherapie noch nicht einsetzbar. Daher soll im zweiten Teil der Übersicht auf die spezielle Situation beim Hörsturz und allgemeine Therapiemöglichkeiten eingegangen werden.

Abstract

The great majority of hearing disorders generates from pathologies in the inner ear, mainly the outer hair cells, as mentioned in the first part of this review. Very often, however, hearing loss appears suddenly and even without external causes like noise exposure. This sudden hearing loss is mostly unilateral, recovers very often spontaneously and should be treated, if persisting. Only in this acute stage there are therapeutic options available. If the inner ear hearing loss is chronic there is no curative therapy, an effective management of the hearing disorder is only possible through rehabilitation. This is due to the fact, that hair cells of all mammals, incl. humans, have no regenerative capacity and neither pharmaceutic agents nor other means can induce regeneration and recovery of hair cells. Even a gen-therapy is not available yet. In the second part of this review the main focus lies in sudden hearing loss and general therapeutic options for inner ear hearing loss.

Schlüsselwörter

Hörsturz - plötzlicher sensorineuraler Hörverlust - intratympanale Kortisontherapie - Hörgeräteversorgung - Hörtherapie

Key words

inner ear hearing loss - sudden sensorineural hearing loss - intratympanic cortison therapy - hearing aids - audiotherapy

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