[Audiologic problems in ENT-practice (author's transl)].
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Biomedical subjects
Publications and source records attributed to P Plath.
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In cases of noise induced hearing loss, the medicolegal judgement of causality often is complicated by the coincidence of endogenous hearing impairments, which conceal the audiological characteristis and the degree of Nihl. The recognition of an occupational disease however is possible only when there is a dominant probability; the possibility of Nihl alone in sight of the labour conditions is not sufficient for this recognition. In such cases, the medical expert therefore, besides of an extensive audiological analysis, must have sufficient information on noise immission, on the course of hearing impairment in regard to working time, and on other diseases and accidents which possibly can influence hearing function.
In cases of noise induced hearing loss, the medico-legal judgement of causality is often complicated by the coincidence of endogenous hearing impairements, which conceal the audiolical characteristics and the degree of NIHL. The recognition of an occupational disease however is possible only when there is a dominant probability; the possibility of NIHL alone in sight of the labour conditions is not sufficient for this recognition. In such cases, the medical expert therefore, besides of an extensive audiological analysis, must have sufficient information on noise immission, on the course of hearing impairement in regard to working time, and on other diseases and accidents which possibly can influence hearing function.
For the sensory cells of Corti's organ are high susceptible to deficits in O2-supply, all disturbances of blood-flow in the inner ear can deteriorate the hearing function. It is the hypotonic dysregulation of the microcirculation in the stria vascularis, which is much more dangerous for the inner ear auditory receptors than be hypertonic disease. The occurance of acute or progredient hearing loss with symptoms of a sensorineural leason and of tinnitus therefore can be looked as an indication to the beginning of a cardiovascular disease, and necessitates appropriate diagnostic and therapy.
Nystagmus as a reaction on vestibular stimulation is influenced by many factors which are difficult to control. One of the most important parameters correlating best with the excitability of the peripheral vestibular apparatus is the speed of the slow phase of the nystagmus. This can be registered directly by use of the nystagmometer (or Blauert System), together with the speed of the fast phase. All parameters of the nystagmus can be easily described when recorded. However, an exact description of the nystagmic reaction should not be considered as a complete diagnosis by itself alone; the diagnosis can only be the result of combining nystagmometry, audiometry and other otoneurological or neurological findings with the patient's presenting complaints (or history of the disease involved).
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