Etiology of Ludwig van Beethoven's hearing disorder - A systematic review

Introduction Even 250 years after Beethoven's birth, the definitive cause of his hearing disorder remains unexplained. The aim of the study is a systematic review of the medical literature of the past 100 years with regard to the most frequent hypotheses.

Material and Methods Systematic review of medical literature between 1920 and 2020 with the search terms "Beethoven", "deafness" and "hearing loss". Included were all studies that dealing with the cause of his hearing loss.

Results 48 studies have been Included. Whereas the majority of the authors in the first half of the study period were otolaryngologists (67 % ), mainly medical experts from other fields studied the cause of the composer's hearing impairment in the last 50 years (81 % ). The most frequently postulated hypotheses were, in descending order, otosclerosis, syphilis, Paget's disease or an unspecified neural etiology. Less frequently immunopathy, sarcoidosis, systematic lupus erythematosus, trauma or labyrinthitis were mentioned in the literature. Recently, the hypothesis of lead intoxication has come up also in the medical literature. The Pro’s and Con’s of the different hypotheses will be critically discussed.

Conclusion Otosclerosis or syphilis have been the most frequently regarded as the underlying cause of Beethoven's hearing disorder. The hypothesis of syphilis has gained an astonishing revival within the last 20 years, especially by authors from other fields. However with respect to the possible benefit of a cochlear implantation as the treatment of choice nowadays a neural cause should be ruled out.

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Artikel online veröffentlicht:
13. Mai 2021