Plontke S, Zenner H-P
Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, Germany.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2004;3:Doc06. Epub 2004 Dec 28.
Hearing loss from occupational and leisure noise numbers amongst the most frequent causes of an acquired sensorineural hearing loss. Here we present a review of up-to-date findings on the pathophysiology of acoustic injury to the inner ear, with special attention being paid to its molecular-biological and genetic aspects. Epidemiological aspects shall also be dealt with, as shall the roles of lacking recovery from occupational noise due to additional exposure by leisure noise and the combined exposure of noise and chemicals. Based on the epidemiological and pathophysiological findings and against the background of published animal-experimental, pre-clinical and clinical findings, the various approaches for prevention, protection and therapeutic intervention with acoustic trauma are discussed. Pharmacological strategies involving anti-oxidative, anti-excitotoxic and anti-apoptotic substances as well as non-pharmacological strategies like "sound conditioning" are given attention. Furthermore, systemic and local substance application as well as the therapy of acute acoustic trauma and chronic hearing problems (including modern therapy forms for comorbidities such as tinnitus) shall be delved into.
职业性和休闲性噪声导致的听力损失是后天性感音神经性听力损失最常见的原因之一。在此，我们对有关内耳声学损伤病理生理学的最新研究结果进行综述，特别关注其分子生物学和遗传学方面。还将探讨流行病学方面的内容，以及休闲噪声额外暴露导致职业性噪声所致听力无法恢复的作用，以及噪声与化学物质的联合暴露。基于流行病学和病理生理学研究结果，并以已发表的动物实验、临床前和临床研究结果为背景，讨论了针对声创伤的各种预防、保护和治疗干预方法。涉及抗氧化、抗兴奋毒性和抗凋亡物质的药理学策略以及“声音调节”等非药理学策略受到关注。此外，还将深入探讨全身和局部用药以及急性声创伤和慢性听力问题（包括耳鸣等合并症的现代治疗形式）的治疗。
