Menière'scher Symptomencomplex infolge traumatischer Labyrinthläsion

Otopathologic Changes in the Cochlea following Head Injury without Temporal Bone Fracture

“…Various terms, such as inner ear concussion , have been given to the clinical observation of hearing loss following head trauma without fracture through the petrous pyramid. A host of historical clinical studies, largely from the early and mid-20th century, addressed this subject, including those by Polizter, 26 Schwartze, 60 Wittmaack, 25 Voss, 24 Brunner, 23 and Schuknecht. 48,54 However, many lacked rigorous methods of diagnosing TB fractures, such as high-resolution imaging, and were not able to provide pathologic correlation.…”

“…17,18 In the absence of a TB fracture, it can be difficult to predict whether a patient will sustain hearing loss after head injury. The terms ''labyrinthine concussion,'' [19][20][21] ''inner ear concussion,'' [22][23][24] ''commotion labyrinthitis,'' 20,25 and ''otitis interna vasomoria'' 23 have been used in the literature since the era of Politzer 26 and are generally defined as head trauma resulting in sensorineural hearing loss without evidence of labyrinthine fracture. Reports of pathology of inner ear concussions, however, are sparse, and this term appears to be a nonspecific catchall phrase for hearing loss following head injury without TB fracture.…”

Labyrinthine concussion: Historic otopathologic antecedents of a challenging diagnosis

“…By the mid‐20th century, however, the causal importance of the pressure wave became increasingly relegated to the acute phase of injury, with theories of vasomotor dysfunction, secondary degenerative changes, and progressive inflammatory states being favored for explaining the chronic deficits of labyrinthine concussion. The importance of a progressive inflammatory state was also alluded to by Politzer who stated that the development of inflammatory tissue along the labyrinth may cause ossification leading to deafness . Degenerative changes in the organ of Corti were observed in the temporal bones of patients with head injury without fracture .…”

“…Another popular explanation for traumatic auditory injury was traction‐related injury to the cochleovestibular nerve. In early studies, Politzer interpreted the significant frequency of blood in the internal auditory canal of human temporal bones after head trauma as suggestive that the vestibulocochlear nerve may frequently be lacerated or its fibers torn in the porus acousticus . Later, Konrad Ulrich (Switzerland) and Walther Uffenorde (Germany), in their respective studies of human otopathology after trauma, concluded that stretching or tearing of the cochlear nerve was the most common and important histologic and pathophysiologic feature .…”