sudden deafness2024-04-15T08:59:10+02:00

sudden deafness

Hearing loss is a sudden loss of hearing with no recognizable external cause.

Possible causes of sudden hearing loss according to the DGHNO guideline “sudden hearing loss” depending on the type of sensorineural hearing loss (IOS):

Hearing loss with high-frequency hearing loss
Depending on the extent of the hearing loss, the probable hearing loss of the sloping or steep drop in the sound threshold in the high frequency range or the inner ear tympanic depression is an insufficiency of the outer hair cells (inner ear hearing loss (IOS) up to approx. 50 dB hearing loss) and/or the inner hair cells (IOS from approx. 60 dB hearing loss).
Hearing loss with low-frequency hearing loss
Based on clinical and animal data, the hearing loss in the low frequency range is probably due to endolymphatic hydrops. A local circulatory disorder of the lamina spiralis with hypoxic tissue damage and disturbance of electrolyte homeostasis is also conceivable.
Hearing loss with pancochlear hearing loss
As all frequencies are affected, even minor hearing losses are subjectively perceived as severe. The main cause of the disease is a functional impairment of the stria vascularis and/or the supplying vessels in the sense of a circulatory disorder and tissue hypoxia.
Hearing loss with mid-frequency hearing loss
The fundamentals of the rare trough-shaped lowering of the tone threshold in the medium frequency range have hardly been investigated. Causes discussed include local circulatory disorders in the area of the lamina spiralis ossea with hypoxic damage (oxygen deficiency) of the organ of Corti and genetic defects.
Hearing loss with deafness / hearing loss bordering on deafness
This form of hearing loss is characterized by the extent of the hearing loss, which usually affects all frequencies. This could be due to a (thrombotic/embolic) occlusion of the common cochlear artery or the spiral modiolar artery with hypoxic strial insufficiency.
This refers to sound threshold curves that can neither be categorized in the groups already mentioned nor assigned to specific IOS types. Its cause is unknown. In a broader sense, this group also includes strongly fluctuating (fluctuating) hearing thresholds and sudden hearing loss with progression of hearing loss under therapy, e.g. due to changes in cerebrospinal fluid pressure and/or immunopathological mechanisms.

What can cause a sudden onset of inner ear hearing loss?
In general, sudden hearing loss is equated with the term acute idiopathic sensorineural hearing loss. The term idiopathic means that the hearing loss has occurred without a recognizable cause. According to a guideline of the German Society for Otorhinolaryngology, Head and Neck Surgery (DGHNO), acute idiopathic sensorineural hearing loss, also known as sudden deafness, is defined as “sudden, usually unilateral sensorineural hearing loss of cochlear origin of varying degrees of severity up to deafness, without an identifiable cause. Dizziness and/or ringing in the ears are also possible” (awmf online, 2009, No. 017/010, Guideline for sudden hearing loss of the German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery). In very few cases can a cause of acute hearing loss be found. A basic distinction is made between hearing loss caused in the inner ear (cochlear), behind the inner ear (retrocochlear) and hearing loss caused in the brain (central). This means that various causes can lead to sudden hearing loss and these causes can come from a wide variety of sources. Looking at the causes of sensorineural hearing loss, Ménière’s disease with endolymphatic hydrops and perilymphatic fistula is a possible cause of acute sensorineural hearing loss. Perilymph fistula is a leakage of inner ear fluid (perilymph) between the inner ear and the middle ear. This is possible, for example, if pressure (barotrauma) causes a tear in the membrane of the round window (entrance port between the middle ear and the inner ear). Drugs that are toxic to the ear (ototoxic drugs) can also cause permanent or temporary damage to the inner ear. These include medications such as furosemide, which is given for high blood pressure or kidney disease, or salicylates, which are used in pain therapy (e.g. aspirin). These can temporarily damage the ear. If the ear is damaged by chemotherapeutic agents (aminoglycosides, cytostatics such as cisplatin) or medication for tuberculosis, the damage is usually reversible. Injuries to the cervical spine, loud acoustic effects such as explosions or significant noise exposure can also cause temporary or permanent damage to the inner ear. Rare diseases of the immune system, such as sarcoidosis or Cogan’s syndrome, can also damage the inner ear. Even rarer are genetic diseases (e.g. Pendred syndrome or Usher syndrome), which can have damaging consequences for the inner ear structures. Inflammation of the inner ear (labyrinthitis) can also occur in infections caused by Lyme disease, measles or mumps infections. If an inflammation of the middle ear is very severe, the inner ear can also be damaged. This is possible in the sense of labyrinthitis or as a result of meningitis. Infections can also damage the auditory nerve. This is referred to as retrocochlear hearing loss. Such infections can be caused, for example, by herpes zoster oticus or other infections such as Borrelia burgdorferi (Lyme borreliosis) or sexually transmitted diseases (lues with the pathogen Treponema pallidum). In very rare cases, HIV can lead to hearing loss. Parasites, e.g. a disease caused by Toxoplasma gondii, can also cause an inner ear infection. If the cause lies in the blood vessels, hearing loss can be caused by an undersupply of blood to the ear due to a blockage (vasospasm) of the supplying inner ear artery (internal auditory artery). A variety of causes, such as heat stress, allergic or psycho-emotional triggers, can cause a change in vascular and blood flow. Bleeding into the inner ear or changes in the large vessels supplying the ear, such as the vertebral artery or basilar artery, are also cited as possible causes of hearing loss.

Can sudden hearing loss be caused by stress?
In practice, we are often asked whether psychological (mental) or physical (bodily) stress can trigger a sudden hearing loss. In fact, fine tissue examinations showed that damaging changes were detectable in the supporting cells of the inner ear. These changes can lead to cell death (necrosis) or slow death (apoptosis). In the event of pathological activation of degradation processes, certain messenger substances (cytokines) are released (IL-1Beta or TNF-Alpha) together with other stress-typical proteins. If these substances are only released for a limited time, the hearing threshold recovers. However, if the activation is prolonged, it results in a permanent loss of the outer hair cells. (Adams JC, Otol Neurotol 2002, 23 (3): p 316-22; Adams et al. Neuroscience 2009 ; 160 (2), p 530-9; Merchant SN, Adams JC and Nadol Jr, Otol Neurotol 2005, 26 (2), p 151-60).

Frequently asked questions

Here we answer the most frequently asked questions

Which medications have dry mouth as a side effect?2024-04-15T08:59:15+02:00

High blood pressure medication, antidepressants and opioids can lead to
lead to dry mouth. However, dry mouth can also be caused by
medication can be strengthened.

What symptoms can occur when the mouth is dry?2024-04-15T08:59:15+02:00

The flow of saliva is important for the mucous membranes of the mouth
and throat. If too little saliva is produced, this can lead to noticeable and
disturbing changes in the oral mucosa: Taste disturbances,
Changes in speech, dry mouth, burning tongue, dry mouth
Lips, bad breath and difficulty swallowing.

What is the cause of a cholesteatoma?2024-04-15T08:59:15+02:00

A cholesteatoma is often caused by an inflammation of the middle ear or a malfunction of the Eustachian tube. This usually results in negative pressure in the middle ear. A so-called epitympanal retraction of the eardrum can occur.

Normally, the Eustachian tube conducts air from the back of the nose into the middle ear. This regulates the normal pressure in the middle ear. An allergic reaction, a cold, a cleft lip and palate, radiation or sinusitis can impair the normal function of the Eustachian tube. A vacuum can develop in the middle ear. The vacuum created sucks in parts of the eardrum that have been weakened by inflammation. This can then be the precursor of a cholesteatoma. Very rarely, there are also congenital cholesteatomas. However, the most common cause of cholesteatomas is ear infections.

Can I park in front of the practice?2024-04-15T08:59:13+02:00

Parking spaces are now available free of charge at the HNO-Center Lucerne. Just ask about the new parking facilities behind the practice if you have an appointment during consultation hours. We will be happy to help you.

Are the operations at the practice on Hünenbergstr. carried out?2024-04-15T08:59:09+02:00

In the practice on Hünenbergstr. we have a practice operating theater that we only use for minor procedures. In principle, we perform all surgical procedures either as outpatients at the Villa Eiche Day Clinic or as inpatients at the Obwalden Cantonal Hospital.

What treatment options are there for dry mouth?2024-04-15T08:59:15+02:00

First of all, the exact diagnosis must be determined. When
another disease is the cause of the dry mouth, the first thing to do is to
the other disease can be treated. If you have diabetes mellitus, you must
the blood sugar level must be adjusted first. If there is a
nasal septum curvature is present, then you should consult a specialist for
Ear, nose and throat diseases discussed about a nasal partition correction
become. Drinking plenty of fluids also has a positive effect, as does the
Use of a humidifier. In the case of nicotine consumption, nicotine consumption should also be
be stopped.

How can Sjögren’s syndrome be diagnosed?2024-04-15T08:59:14+02:00

The body produces antibodies that can be detected in the blood. The antibodies against Sjögren’s syndrome can be determined with a blood test.
(SS-A and SS-B antibodies). Through a microscopic examination
a tissue sample taken from the inside of the lips, the specialist for
ear, nose and throat diseases can prove the diagnosis of Sjögren’s syndrome.

What are the causes of dry mouth?2024-04-15T08:59:13+02:00

The causes of dry mouth can vary.
As part of the natural ageing process, the number and quality of
of the saliva-producing cells. Obstructed nasal breathing can also be a
Increase dry mouth. Occasionally, dry mouth is also a
Symptom of another disease. Saliva production may be reduced
for autoimmune diseases, diabetes mellitus, hepatitis C,
Parkinson’s disease, Alzheimer’s disease and HIV. Also hormonal causes (menopause)
or nicotine abuse can lead to a dry mouth. In Sjögren’s syndrome
dry mouth is often accompanied by dry eyes.

What do I do if I have an enlarged thyroid?2024-04-15T08:59:15+02:00

Sometimes nodules can develop in the thyroid gland. The growth
the knot can sometimes be slow or fast. Patients who have a
have undergone radiotherapy in the head or neck area are particularly prone to
to develop thyroid disease. If the nodes are
growth, it is usually advisable to surgically remove the
thyroid gland.

A thyroid dysfunction or a thyroid nodule is called
diagnosed by taking a medical history and performing an examination.
is carried out. In particular, your doctor will examine your throat and
ask you to lift your chin to allow the thyroid gland to protrude more.
During the examination you will be asked to swallow, which will
helps to feel the thyroid gland and the nodules in it. Depending on
If necessary, arrange for further investigations. In most cases, an ultrasound examination
of your neck and thyroid and laboratory tests of the thyroid gland.
blood to check thyroid function. Likewise, a
thyroid scintigraphy with radioactive iodine may be necessary. Your
doctor performs a fine-needle examination of the thyroid gland, an X-ray examination of the
chest or, in rare cases, computerized tomography or MRI examination for
consider necessary

What are the treatment options for snoring?2024-04-15T08:59:14+02:00

Uvulo-palato-pharyngoplasty (UPPP) is a surgical procedure that is used to treat severe snoring caused by sleep apnea. The procedure is based on shortening the loose tissue of the palate, in particular the elongated uvula (uvula of the palate). The aim of the operation is to tighten the soft palate on the one hand and to shorten the soft palate while preserving the natural soft palate muscle (uvulae muscle) on the other. The front of the mucous membrane of the uvula is removed and sutured to the palate in such a way that the uvula is shortened. As a result, the uvula no longer rests on the base of the tongue. This expands the air passage. The procedure is associated with a short inpatient stay of one to three days. In very rare cases, risks may occur during this procedure. These risks include infections, bleeding, impaired wound healing, post-operative bleeding, speech impairment in the form of open nasal passages, dental damage, temporary to permanent difficulty swallowing and the very rare risk of thrombosis (embolism) during an operation under anesthesia. The ability to swallow is restricted for around 14 days after the procedure, as pain may occur. The pain will be easily treatable with medication. Antibiotic treatment is typically not necessary. In addition to these surgical measures, accompanying, non-surgical measures should be considered by the patient. In addition to these measures, it is important to maintain a healthy and sporty lifestyle in order to achieve good muscle tone and reduce weight. Medication that causes drowsiness, such as sedatives, sleeping pills or antihistamines, should no longer be taken at night. Alcohol should also be avoided as a matter of principle. You should also sleep on your side rather than on your back. A slight tilt of the head upwards usually has a positive effect. A normal sleep rhythm is just as beneficial. Alcohol should be avoided about 4 hours before going to bed and heavy meals about 3 hours before.

Are nasal tamponades inserted during nasal surgery?2024-04-15T08:59:08+02:00

In principle, the insertion of nasal tamponades is not necessary when correcting the nasal septum or correcting the outer nose. How long will I be unable to work after a rhinoplasty? In the case of rhinoplasty surgery or correction of the nasal septum, the patient is usually unable to work for around 14 days.

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