Objective: To discuss the possible etiology, pathogenesis and ‘cure’ of idiopathic sudden deafness (SD). Method: A review was made of different methods for the study of inner-ear physiology, especially its microcirculation, relating them to clinical evaluation and praxis for SD. Results: Cochlear blood flow (CBF) can be measured quantitatively with the microsphere method in animals. Direct qualitative measurements can be performed using the laser Doppler method. The CBF is partly autoregulated, but to a lesser degree than cerebral blood flow. Sympathetic stimulation decreases CBF up to 25%. Noise does not influence total CBF but seems to reduce blood flow in the lateral wall. Nicotinic acid, hemodilution and osmotic drugs increase the CBF proportionally. Carbogen increases the CBF but also creates acidosis. Treating patients with SD in accordance with these findings does not show any convincing effect compared to no treatment. Conclusion: More and more diseases have been identified which can have SD as a symptom. It is important to investigate to identify these treatable cases. Idiopathic cases should not be exposed to hazardous systemic medication or surgery. Local treatment through the round window will be the treatment modality for the future, but more basic research is necessary.

Keywords:
Cochlear blood flow, Sudden deafness
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© 2000 S. Karger AG, Basel
2000
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