Aktuelle Gesichtspunkte zu Hörschäden durch Berufs- und Freizeitlärm

Zusammenfassung

Hörschäden durch Berufs- und Freizeitlärm gehören zu den häufigsten Ursachen einer erworbenen Innenohrschwerhörigkeit. Die vorliegende Arbeit gibt eine Übersicht über die aktuellen Erkenntnisse zur Pathophysiologie der Lärmschädigung des Innenohres unter besonderer Berücksichtigung moderner molekularbiologischer und genetischer Aspekte. Ebenso werden epidemiologische Gesichtspunkte, insbesondere die Bedeutung fehlender Lärmerholungspausen durch zusätzliche Exposition mit Freizeitlärm und die kombinierte Exposition mit Lärm und Chemikalien betrachtet. Ausgehend von den Erkenntnissen zur Epidemiologie und Pathophysiologie werden vor dem Hintergrund der aktuellen wissenschaftlichen Literatur zu tierexperimentellen präklinischen und klinischen Studien die unterschiedlichen Ansatzpunkte der Prävention, Protektion und therapeutischen Intervention bei Schalltrauma diskutiert. Dabei finden sowohl pharmakologische Strategien, wie z. B. mit antioxidativen, antiexzitotoxischen, antiapoptotischen u. a. Substanzen, als auch nichtpharmakologische Strategien wie die Schallkonditionierung Berücksichtigung. Weiterhin werden die systemische und lokale Applikation sowie die Therapie des akuten Schalltraumas und der chronischen Lärmschwerhörigkeit einschließlich moderner Therapieformen für Komorbiditäten wie Tinnitus erläutert.

Schlüsselwörter

Akutes akustisches Trauma - Berufslärm - Freizeitlärm - chronische Lärmschwerhörigkeit - Prävention - Therapie

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0 Teile der Abschnitte 6.4 und 6.5 wurden mit freundlicher Genehmigung teilweise entnommen aus: Zenner et al. HNO 47, 1999, 236 - 248 [7].

1 Wir danken Dr. H. Löwenheim, Tübingen, für die kritische Durchsicht dieses Kapitels.