<?xml version="1.0" encoding="ISO-8859-1"?><cms:container xmlns:cms="http://edoc.hu-berlin.de/diml/module/cms"><cms:document><cms:meta><cms:entry ref="front" type="front"/><cms:entry type="title">Die Aussagekraft der Umfelddiagnostik bezüglich der  sekundären Prävention beim Hörsturz Eine retrospektive Studie</cms:entry><cms:entry type="author">Halil Ibrahim </cms:entry><cms:entry ref="N10035" type="pagenumber">2</cms:entry><cms:entry ref="N1004E" type="pagenumber">3</cms:entry><cms:entry id="chapter1" part="chapter1" ref="chapter1" type="chapter">1</cms:entry><cms:entry id="N10084" part="chapter1" ref="N10084" type="pagenumber">6</cms:entry><cms:entry id="chapter2" part="chapter2" ref="chapter2" type="chapter">2</cms:entry><cms:entry id="N100A6" part="chapter2" ref="N100A6" type="pagenumber">7</cms:entry><cms:entry id="N100AB" part="chapter2" ref="N100AB" type="section">2.1</cms:entry><cms:entry id="N100EB" part="chapter2" ref="N100EB" type="section">2.2</cms:entry><cms:entry id="N100EF" part="chapter2" ref="N100EF" type="pagenumber">8</cms:entry><cms:entry id="N10113" part="chapter2" ref="N10113" type="section">2.3</cms:entry><cms:entry id="N10147" part="chapter2" ref="N10147" type="pagenumber">9</cms:entry><cms:entry id="N10184" part="chapter2" ref="N10184" type="pagenumber">10</cms:entry><cms:entry id="N101CB" part="chapter2" ref="N101CB" type="pagenumber">11</cms:entry><cms:entry id="N1020D" part="chapter2" ref="N1020D" type="section">2.4</cms:entry><cms:entry id="N10211" part="chapter2" ref="N10211" type="pagenumber">12</cms:entry><cms:entry id="N1022A" part="chapter2" ref="N1022A" type="table"/><cms:entry id="_987760390" part="chapter2" ref="_987760390" type="link"/><cms:entry id="_987760532" part="chapter2" ref="_987760532" type="link"/><cms:entry id="_988104630" part="chapter2" ref="_988104630" type="link"/><cms:entry id="N1025A" part="chapter2" ref="N1025A" type="mm">338#246</cms:entry><cms:entry id="N1026F" part="chapter2" ref="N1026F" type="section">2.5</cms:entry><cms:entry id="N10273" part="chapter2" ref="N10273" type="pagenumber">13</cms:entry><cms:entry id="N1029D" part="chapter2" ref="N1029D" type="section">2.6</cms:entry><cms:entry id="N102C7" part="chapter2" ref="N102C7" type="pagenumber">14</cms:entry><cms:entry id="N102F7" part="chapter2" ref="N102F7" type="pagenumber">15</cms:entry><cms:entry id="N10315" part="chapter2" ref="N10315" type="pagenumber">16</cms:entry><cms:entry id="N10319" part="chapter2" ref="N10319" type="mm">610#681</cms:entry><cms:entry id="N1032C" part="chapter2" ref="N1032C" type="section">2.7</cms:entry><cms:entry id="N10330" part="chapter2" ref="N10330" type="pagenumber">17</cms:entry><cms:entry id="N1036C" part="chapter2" ref="N1036C" type="section">2.8</cms:entry><cms:entry id="N10370" part="chapter2" ref="N10370" type="pagenumber">18</cms:entry><cms:entry id="N10383" part="chapter2" ref="N10383" type="table"/><cms:entry id="N103AA" part="chapter2" ref="N103AA" type="mm">627#323</cms:entry><cms:entry id="N103B9" part="chapter2" ref="N103B9" type="section">2.9</cms:entry><cms:entry id="N103BD" part="chapter2" ref="N103BD" type="pagenumber">19</cms:entry><cms:entry id="N103FB" part="chapter2" ref="N103FB" type="pagenumber">20</cms:entry><cms:entry id="N10402" part="chapter2" ref="N10402" type="table"/><cms:entry id="N104DF" part="chapter2" ref="N104DF" type="pagenumber">21</cms:entry><cms:entry id="N104E6" part="chapter2" ref="N104E6" type="table"/><cms:entry id="N109CD" part="chapter2" ref="N109CD" type="pagenumber">22</cms:entry><cms:entry id="chapter3" part="chapter3" ref="chapter3" type="chapter">3</cms:entry><cms:entry id="N10A14" part="chapter3" ref="N10A14" type="pagenumber">23</cms:entry><cms:entry id="N10A19" part="chapter3" ref="N10A19" type="section">3.1</cms:entry><cms:entry id="N10A2F" part="chapter3" ref="N10A2F" type="mm">545#327</cms:entry><cms:entry id="N10A43" part="chapter3" ref="N10A43" type="pagenumber">24</cms:entry><cms:entry id="N10A4D" part="chapter3" ref="N10A4D" type="table"/><cms:entry id="N10B52" part="chapter3" ref="N10B52" type="mm">547#358</cms:entry><cms:entry id="N10B65" part="chapter3" ref="N10B65" type="section">3.2</cms:entry><cms:entry id="N10B69" part="chapter3" ref="N10B69" type="pagenumber">25</cms:entry><cms:entry id="N10B70" part="chapter3" ref="N10B70" type="mm">614#556</cms:entry><cms:entry id="N10B7F" part="chapter3" ref="N10B7F" type="subsection">3.2.1</cms:entry><cms:entry id="N10B83" part="chapter3" ref="N10B83" type="pagenumber">26</cms:entry><cms:entry id="N10B8D" part="chapter3" ref="N10B8D" type="table"/><cms:entry id="N10BD0" part="chapter3" ref="N10BD0" type="table"/><cms:entry id="N10C0A" part="chapter3" ref="N10C0A" type="table"/><cms:entry id="N10C44" part="chapter3" ref="N10C44" type="table"/><cms:entry id="N10C7E" part="chapter3" ref="N10C7E" type="table"/><cms:entry id="N10CB8" part="chapter3" ref="N10CB8" type="table"/><cms:entry id="N10CF5" part="chapter3" ref="N10CF5" type="pagenumber">27</cms:entry><cms:entry id="N10D05" part="chapter3" ref="N10D05" type="table"/><cms:entry id="N10D3F" part="chapter3" ref="N10D3F" type="section">3.3</cms:entry><cms:entry id="N10D60" part="chapter3" ref="N10D60" type="pagenumber">28</cms:entry><cms:entry id="N10D6C" part="chapter3" ref="N10D6C" type="table"/><cms:entry id="N10DA4" part="chapter3" ref="N10DA4" type="subsection">3.3.1</cms:entry><cms:entry id="N10DD8" part="chapter3" ref="N10DD8" type="pagenumber">29</cms:entry><cms:entry id="chapter4" part="chapter4" ref="chapter4" type="chapter">4</cms:entry><cms:entry id="N10E31" part="chapter4" ref="N10E31" type="pagenumber">30</cms:entry><cms:entry id="N10E36" part="chapter4" ref="N10E36" type="section">4.1</cms:entry><cms:entry id="N10E3B" part="chapter4" ref="N10E3B" type="subsection">4.1.1</cms:entry><cms:entry id="N10E50" part="chapter4" ref="N10E50" type="mm">604#285</cms:entry><cms:entry id="N10E63" part="chapter4" ref="N10E63" type="subsection">4.1.2</cms:entry><cms:entry id="N10E67" part="chapter4" ref="N10E67" type="pagenumber">31</cms:entry><cms:entry id="N10EA7" part="chapter4" ref="N10EA7" type="pagenumber">32</cms:entry><cms:entry id="N10EB4" part="chapter4" ref="N10EB4" type="table"/><cms:entry id="N10FE4" part="chapter4" ref="N10FE4" type="pagenumber">33</cms:entry><cms:entry id="N10FEE" part="chapter4" ref="N10FEE" type="mm">605#387</cms:entry><cms:entry id="N11008" part="chapter4" ref="N11008" type="pagenumber">34</cms:entry><cms:entry id="N1100C" part="chapter4" ref="N1100C" type="mm">604#362</cms:entry><cms:entry id="N11022" part="chapter4" ref="N11022" type="subsection">4.1.3</cms:entry><cms:entry id="N1102B" part="chapter4" ref="N1102B" type="subsection">4.1.4</cms:entry><cms:entry id="N11037" part="chapter4" ref="N11037" type="subsection">4.1.5</cms:entry><cms:entry id="N1103B" part="chapter4" ref="N1103B" type="pagenumber">35</cms:entry><cms:entry id="N1104E" part="chapter4" ref="N1104E" type="table"/><cms:entry id="N1111A" part="chapter4" ref="N1111A" type="subsection">4.1.6</cms:entry><cms:entry id="N1112C" part="chapter4" ref="N1112C" type="subsection">4.1.7</cms:entry><cms:entry id="N11130" part="chapter4" ref="N11130" type="pagenumber">36</cms:entry><cms:entry id="N1113C" part="chapter4" ref="N1113C" type="subsection">4.1.8</cms:entry><cms:entry id="N1117F" part="chapter4" ref="N1117F" type="pagenumber">37</cms:entry><cms:entry id="N111CB" part="chapter4" ref="N111CB" type="pagenumber">38</cms:entry><cms:entry id="N111D2" part="chapter4" ref="N111D2" type="table"/><cms:entry id="N1132B" part="chapter4" ref="N1132B" type="table"/><cms:entry id="N113EB" part="chapter4" ref="N113EB" type="pagenumber">39</cms:entry><cms:entry id="N113FC" part="chapter4" ref="N113FC" type="section">4.2</cms:entry><cms:entry id="N1141A" part="chapter4" ref="N1141A" type="pagenumber">40</cms:entry><cms:entry id="N11457" part="chapter4" ref="N11457" type="pagenumber">41</cms:entry><cms:entry id="N1145E" part="chapter4" ref="N1145E" type="mm">604#388</cms:entry><cms:entry id="N1147E" part="chapter4" ref="N1147E" type="pagenumber">42</cms:entry><cms:entry id="N11485" part="chapter4" ref="N11485" type="mm">604#249</cms:entry><cms:entry id="N1149D" part="chapter4" ref="N1149D" type="section">4.3</cms:entry><cms:entry id="N114A9" part="chapter4" ref="N114A9" type="section">4.4</cms:entry><cms:entry id="N114B9" part="chapter4" ref="N114B9" type="pagenumber">43</cms:entry><cms:entry id="N114EA" part="chapter4" ref="N114EA" type="table"/><cms:entry id="N11599" part="chapter4" ref="N11599" type="section">4.5</cms:entry><cms:entry id="N115BF" part="chapter4" ref="N115BF" type="pagenumber">44</cms:entry><cms:entry id="N115D8" part="chapter4" ref="N115D8" type="mm">509#250</cms:entry><cms:entry id="N115EC" part="chapter4" ref="N115EC" type="pagenumber">45</cms:entry><cms:entry id="chapter5" part="chapter5" ref="chapter5" type="chapter">5</cms:entry><cms:entry id="N11605" part="chapter5" ref="N11605" type="pagenumber">46</cms:entry><cms:entry id="N1161B" part="chapter5" ref="N1161B" type="pagenumber">47</cms:entry><cms:entry id="N1163C" part="chapter5" ref="N1163C" type="pagenumber">48</cms:entry><cms:entry id="N1165C" part="chapter5" ref="N1165C" type="pagenumber">49</cms:entry><cms:entry id="N11666" part="chapter5" ref="N11666" type="mm">604#350</cms:entry><cms:entry id="N11686" part="chapter5" ref="N11686" type="pagenumber">50</cms:entry><cms:entry id="N116B1" part="chapter5" ref="N116B1" type="pagenumber">51</cms:entry><cms:entry id="N116E1" part="chapter5" ref="N116E1" type="pagenumber">52</cms:entry><cms:entry id="N1170C" part="chapter5" ref="N1170C" type="pagenumber">53</cms:entry><cms:entry id="N11733" part="chapter5" ref="N11733" type="pagenumber">54</cms:entry><cms:entry id="N11758" part="chapter5" ref="N11758" type="pagenumber">55</cms:entry><cms:entry id="N1179E" part="chapter5" ref="N1179E" type="pagenumber">56</cms:entry><cms:entry id="chapter6" part="chapter6" ref="chapter6" type="chapter">6</cms:entry><cms:entry id="N117B4" part="chapter6" ref="N117B4" type="pagenumber">57</cms:entry><cms:entry ref="N117CD" type="back"/><cms:entry id="N117CF" part="N117CF" ref="N117CF" type="bibliography">
				Literatur:</cms:entry><cms:entry id="N117D3" part="N117CF" ref="N117D3" type="pagenumber">58</cms:entry><cms:entry id="N118DA" part="N117CF" ref="N118DA" type="pagenumber">59</cms:entry><cms:entry id="N11A02" part="N117CF" ref="N11A02" type="pagenumber">60</cms:entry><cms:entry id="N11B24" part="N117CF" ref="N11B24" type="pagenumber">61</cms:entry><cms:entry id="N11C39" part="N117CF" ref="N11C39" type="pagenumber">62</cms:entry><cms:entry id="N11D3B" part="N117CF" ref="N11D3B" type="pagenumber">63</cms:entry><cms:entry id="N11E3D" part="N117CF" ref="N11E3D" type="pagenumber">64</cms:entry><cms:entry id="N11EE7" part="N11EE7" ref="N11EE7" type="vita">
				Lebenslauf:</cms:entry><cms:entry id="N11EEB" part="N11EE7" ref="N11EEB" type="pagenumber">65</cms:entry><cms:entry id="N11EF2" part="N11EE7" ref="N11EF2" type="table"/><cms:entry id="N12141" part="N12141" ref="N12141" type="declaration">
				Erklärung</cms:entry><cms:entry id="N12145" part="N12141" ref="N12145" type="pagenumber">66</cms:entry><cms:entry part="front" type=":current"/><cms:entry type=":lang">de</cms:entry><cms:entry ref=":contents" type=":contents">Inhaltsverzeichnis</cms:entry><cms:entry type=":help"><url href="http://...">Hilfe</url></cms:entry></cms:meta><cms:content><front id="front"><school>Aus der Hals &#8211; Nasen &#8211; Ohrenklinik und Poliklinik<br/>der Medizinischen Fakultät Charité,<br/>der Humboldt - Universität zu Berlin <br/>Campus Virchow - Klinikum <br/>Direktor: Prof. Dr. med. Jahnke</school><submission>DISSERTATION</submission><title>Die Aussagekraft der Umfelddiagnostik bezüglich der <br/>sekundären Prävention beim Hörsturz<br/>Eine retrospektive Studie</title><degree>Zur Erlangung des akademischen Grades<br/>Doctor medicinae </degree><major>vorgelegt der Medizinischen Fakultät Charité<br/>der Humboldt-Universität zu Berlin</major><author>von<br/>
			<given>Halil Ibrahim</given> Ya&#351;ar<br/>
			<suffix>aus Mu&#351; (Türkei)</suffix>
		</author><p>
			<pagenumber id="N10035" label="2" numbering="arabic" start="2"/>
		</p><dean>Dekan: Prof. Dr. med. Dr. h. c. Felix</dean><approvals>
			<name>Dr. Dr. med. Knöbber</name>
			<name>Prof. Dr. med. H.Behrbohm</name>
			<name>Prof. Dr. med. H. Scherer</name>
		</approvals><date>Promoviert am : 16. November 2000</date><freehead>
			<pagenumber id="N1004E" label="3" numbering="arabic" start="3"/>Vorbemerkung</freehead><p>Bedingt durch die Berliner Hochschulsituation erfolgte die Fusion des Universitätsklinikums Charlottenburg (FU Berlin) mit dem Rudolf-Virchow-Krankenhaus zum Universitätsklinikum Rudolf-Virchow, Medizinische Fakultät der Freien Universität Berlin. In diese Zeit fällt die stationäre Aufnahme der Patienten, die Gegenstand der vorliegenden Untersuchung sind.</p><p>Seit dem 01.04.1995 gehört die Klinik unter dem Namen Virchow-Klinikum zur Medizinischen Fakultät der Humboldt-Universität zu Berlin.</p><p>Die beiden Hals-Nasen-Ohrenkliniken des Virchow-Klinikums und der Charité fusionierten zum 01.04.1997.</p><p>Die endgültige Fusion beider Universitätskliniken unter dem Namen Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin mit den jeweiligen Zusätzen Campus Charité Mitte und Campus Virchow-Klinikum erfolgte zum 01.01.1998.</p><keywords lang="de">
		<keyword>Hörsturz</keyword>
		<keyword>Diagnostik</keyword>
		<keyword>Risikofaktoren</keyword>
		<keyword>sekundäre Prävention</keyword></keywords><keywords lang="en">
		<keyword>sudden deafness</keyword>
		<keyword>diagnosis</keyword>
		<keyword>risk factors</keyword>
		<keyword>prevention secondary
		</keyword></keywords><freehead id=":contents">Inhaltsverzeichnis</freehead><ul><li><p><link ref="chapter1">1</link> 
				Problemstellung </p></li><li><p><link ref="chapter2">2</link> 
				Darstellung des Krankheitsbildes<ul><li><p><link ref="N100AB">2.1</link> Zur Geschichte des Hörsturzes </p></li><li><p><link ref="N100EB">2.2</link> 
					Synonyma und Definition </p></li><li><p><link ref="N10113">2.3</link> Ätiologie und Pathogenese </p></li><li><p><link ref="N1020D">2.4</link> 
					Epidemiologie </p></li><li><p><link ref="N1026F">2.5</link> 
					Symptomatik </p></li><li><p><link ref="N1029D">2.6</link> Diagnostik </p></li><li><p><link ref="N1032C">2.7</link> 
					Risikofaktoren </p></li><li><p><link ref="N1036C">2.8</link> 
					Differentialdiagnose </p></li><li><p><link ref="N103B9">2.9</link> 
					Therapie </p></li></ul></p></li><li><p><link ref="chapter3">3</link> 
				Patientengut und Methodik<ul><li><p><link ref="N10A19">3.1</link> Patientengut</p></li><li><p><link ref="N10B65">3.2</link> 
					Auswertungskriterien<ul><li><p><link ref="N10B7F">3.2.1</link> 
						Untersuchungsvorlage</p></li></ul></p></li><li><p><link ref="N10D3F">3.3</link> Konsiliaruntersuchungen:<ul><li><p><link ref="N10DA4">3.3.1</link> Risikofaktoren und ihre Referenzbereiche:</p></li></ul></p></li></ul></p></li><li><p><link ref="chapter4">4</link> 
				Ergebnisse<ul><li><p><link ref="N10E36">4.1</link> Diagnostik<ul><li><p><link ref="N10E3B">4.1.1</link> Anamnese</p></li><li><p><link ref="N10E63">4.1.2</link> 
						Tonaudiometrie</p></li><li><p><link ref="N11022">4.1.3</link> Stapediusreflex</p></li><li><p><link ref="N1102B">4.1.4</link> Otologischer Spiegelbefund</p></li><li><p><link ref="N11037">4.1.5</link> 
						BERA ( brainstem evoced response audiometry )</p></li><li><p><link ref="N1111A">4.1.6</link> ENG ( Elektronystagmographie )</p></li><li><p><link ref="N1112C">4.1.7</link> 
						Virologie</p></li><li><p><link ref="N1113C">4.1.8</link> Konsiliaruntersuchungen</p></li></ul></p></li><li><p><link ref="N113FC">4.2</link> Risikofaktoren</p></li><li><p><link ref="N1149D">4.3</link> Therapiezeit</p></li><li><p><link ref="N114A9">4.4</link> Therapie</p></li><li><p><link ref="N11599">4.5</link> Remissionsverhalten</p></li></ul></p></li><li><p><link ref="chapter5">5</link> 
				Diskussion</p></li><li><p><link ref="chapter6">6</link> 
				Zusammenfassung:</p></li><li><p><link ref="N117CF">
				Literatur:</link></p></li><li><p><link ref="N11EE7">
				Lebenslauf:</link></p></li><li><p><link ref="N12141">
				Erklärung</link></p></li></ul><freehead id=":toc-tables">Tabellen</freehead><ul><li><p><link ref="N1022A">
							<u>Tabelle </u>
							<u>1</u>
							<u>:</u> Altersverteilung von 1032 Patienten (Daten nach STANGE &amp; NEVELING und BERG &amp; PALLASCH)</link></p></li><li><p><link ref="N10383">
							<u>Tabelle </u>
							<u>2</u>
							<u>:</u>Übersicht über mögliche Ursachen plötzlicher Ertaubung nach NEVELING (1967)</link></p></li><li><p><link ref="N10402">
							<u>Tabelle </u>
							<u>3</u>
							<u>:</u> Einige Therapiemöglichkeiten aus der Literatur</link></p></li><li><p><link ref="N104E6">
							<u>Tabelle </u>
							<u>4</u>
							<u>: </u>Therapeutische Erfolge von 16 Autoren bei Anwendung von unterschiedlichen Pharmaka (Michel 1994)</link></p></li><li><p><link ref="N10A4D">Tabelle 5:</link></p></li><li><p><link ref="N10EB4">
								<u>Tabelle 6 :</u> Einteilung der Hörverluste in Gruppen</link></p></li><li><p><link ref="N1104E">
								<u>Tabelle 7 :</u> Übersicht über die BERA-Untersuchung</link></p></li><li><p><link ref="N111D2">
								<u>Tabelle 8:</u> Pathologische HWS-Veränderungen (n = 61) in verschiedenen Altersgruppen</link></p></li><li><p><link ref="N1132B">
								<u>Tabelle 9</u>: Überblick über die Art und Verteilung der HWS-Störungen bei n = 114</link></p></li><li><p><link ref="N114EA">
							<u>Tabelle 10:</u> Die häufigsten Kombinationen zeigt die Tabelle 10 an.</link></p></li></ul><freehead id=":toc-media">Bilder</freehead><ul><li><p><link ref="N10319">
							<u>Abbildung </u>
							<u>1</u>
							<u>:</u> Flußdiagramm der wichtigsten diagnostischen und therapeutischen Schritte beim Hörsturz nach ALBEGGER u. OBERASCHER ( 1992 ):</link></p></li><li><p><link ref="N10A2F">
							<u>Abbildung </u>
							<u>2</u>
							<u>:</u> Geschlechtsverteilung (n = 119 )</link></p></li><li><p><link ref="N10B52">
							<u>Abbildung </u>
							<u>3</u>
							<u>:</u> Anzahl der weiblichen und männlichen Patienten in einzelnen Altersgruppen</link></p></li><li><p><link ref="N10B70">
							<u>Abbildung </u>
							<u>4</u>: Untersuchungsvorlage für den Hörsturz</link></p></li><li><p><link ref="N10E50">
								<u>Abbildung </u>
								<u>5</u>
								<u>:</u> Angaben über die Häufigkeit der Symptome</link></p></li><li><p><link ref="N10FEE">
								<u>Abbildung </u>
								<u>6</u>
								<u>:</u> Anzahl der Patienten mit Hörverlusten im Tiefton- , Mittelton- u. Hochtonbereich</link></p></li><li><p><link ref="N1100C">
								<u>Abbildung </u>
								<u>7</u>
								<u>:</u> Hörverlust im Mitteltonbereich bei den unterschiedlichen Altersgruppen</link></p></li><li><p><link ref="N1145E">
							<u>Abbildung </u>
							<u>8</u>
							<u>:</u> Die Pat.-Zahl der einzelnen Risikofaktoren bezieht sich jeweils auf 119 Patienten</link></p></li><li><p><link ref="N11485">
							<u>Abbildung </u>
							<u>9</u>
							<u>:</u> Die Anzahl der Patienten mit x-Risikofaktoren (RF) ; n=119</link></p></li><li><p><link ref="N115D8">
							<u>Abbildung </u>
							<u>10</u>
							<u>: </u>Remissionsverhalten der 119 Patienten nach der Therapie</link></p></li><li><p><link ref="N11666">
						<u>Abbildung </u>
						<u>11</u>
						<u>: </u>Übersicht über die altersabhängigen HWS-Veränderungen</link></p></li></ul></front></cms:content></cms:document></cms:container>