PROGRESSIVE SENSORINEURAL HEARING-LOSS - PATHOPHYSIOLOGY, DIFFERENTIAL-DIAGNOSIS AND THERAPEUTIC CONCEPTS

Progressive sensorineural hearing loss (SNHL) is still a challenge to the otorhinolaryngologist. It can be solved only by a systematic and i nterdisciplinary approach to the patient and his disease. Most often a n acute onset is observed with a non-linear, sometimes dramatic progre ss to chronicity and complete deafness. Cardiovascular and rheologic d iseases, hereditary disorders, immunological phenomena, hormonal and m etabolic derailments, infections, environmental causes like noise, oto toxic drugs and industrial substances and systemic maladies must be in cluded in the diagnostic reflections. Otopathy is an idiopathic hearin g loss which cannot be classed with the above mentioned disorders. Whe rever possible a causal therapy should be carried out. Symptomatic the rapeutic concepts include theologic medications, corticosteroids or, w ith all reservation, cytotoxic drugs. Hearing aids should be prescribe d in close relation to the dynamic deterioration of the hearing. The t imely cochlear implant operation stands at the end of the therapeutic scale.