[Speech audiometry in the diagnosis of cerebrovascular disorders].

Audiometrical methods can be used objectively for the diagnosis of functional cerebrovascular disorders. Especially the speechaudiometrical examination extends the possibilities of previous noninvasive and invasive procedures (ultrasonic-Doppler-examination, angiography, nuclear-medical investigations, computertomography). With that follows new tasks for the otorhinolaryngological physician as he is able to impart his main statements to other physicians (particularly to internists inclusive angiologists and neurologists). Between 1976 and 959 adults with functional cerebrovascular impairments audiometrically examined. To about 10 percent of the pure-tone audiometrical curves to explicable alteration was to be found. Deviation in the speechaudiogram without relation to the pure-tone audiometrical curve was proved in 50 to 60 percent. The important statements represent the pathological loss of the discrimination in the speechaudiogram. The results are discussed according to the following classified diseases: a) general cerebral vascular functional disorders, b) obliterations of extra and intra cranial vessels (e.g. stenosis of the carotid artery), c) cerebral dysfunctions (e.g. alcohol and phenacetin abuse, cranial brain injury, dementia). Each exclusion of an acoustic impairments which can be casually not be distinguished should involve the examination of the extra and intra cranial vessels because very often the loss of discrimination of the speech-audiogram (and sometimes also no confirmed puretone audiometrical result) is valued as leading symptom for obliteration. The connexion from ultrasonic-Doppler examination and speechaudiometry may be used as screening method in order to conform the suspicion for an carotid stenosis in cases of unclear etiology.