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
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1 Wir danken Dr. H. Löwenheim, Tübingen, für die kritische Durchsicht dieses Kapitels.
Dr. med. Stefan Plontke
Klinik für Hals-, Nasen- und Ohrenheilkunde am Universitätsklinikum Tübingen ·
Elfriede-Aulhorn-Straße 5 · 72076 Tübingen
Email: Stefan.Plontke@uni-tuebingen.de
