[Sudden deafness in old age].

The sudden hearing impairment sensu stricture constitutes an otologic emergency, the genesis of which is still a mystery. The one-sided, reduced auditory sensitivity (labyrinthine deafness, sensorineural lesion) occurs unexpectedly and, more often than not, in good general condition with the remaining otologic diagnosis showing almost no anomalies. The cause for this impairment is considered to be a cochlear malfunctioning of the microcirculation with ensuing hypoxia/anoxia in stria vascularis and in Corti's organ, which is caused by a change in the circulation qualities of the blood (hemagglutination, aggregation of thrombocytes etc.) sometimes in the wake of a viral infection. Although sometimes spontaneous remissions of the sense of hearing occur in subjects suffering from a sudden hearing impairment - with no prognostic parameter, however - it is of utmost importance to start therapy immediately after the first symptoms have occurred. Therapeutic measures should aim at a reactivation of the impaired microcirculation in order to eliminate the lack of oxygen in the areas concerned. In addition to the indispensable internal treatment, it is recommended to use dextran of low molecular weight to attain hemodilution as well as aggregation inhibitors to improve the rheologic qualities of the blood.