[Accident-related inner ear diseases - clinical aspects and conditions]

Trauma-related inner ear disorders following head impacts can have various causes. The use of the more recent classification of temporal bone fractures into "otic capsule sparing" (OCS) and "otic capsule violating" (OCV) is useful in the context of medical assessment. The available imaging is often insufficient, and the consequences of otic capsule fractures are underestimated in emergency management. Therefore, indirect signs (e. g., hemotympanum, cerebrospinal fluid otorrhea, facial palsy) often must be evaluated. Even without radiological evidence of a fracture, temporary inner ear damage can occur, particularly through the mechanism of a head-impact acoustic trauma. Typical findings include hearing loss with a c5-notch, sometimes accompanied by tinnitus, and benign paroxysmal positional vertigo (BPPV) respectively. Persistent disorders may result not only from fractures but also from hemorrhage within the labyrinth. However, these are rarely detected in acute diagnostics and are therefore difficult to prove causally. If vertigo and dizziness persist after a head injury and symptoms worsen, persistent postural-perceptual dizziness (PPPD, functional dizziness syndrome) must be considered. Tinnitus invariably occurs in combination with a structurally and objectively verifiable hearing impairment.