In a psychosomatic point of view in an overwhelming number of cases sudden deafness is a "response" to strain, which consciously or unconsciously is not assessed as tolerable. Special personal or situational circumstances seem to occur frequently, besides of psychomental strain above all high pressure of responsibility in situations of care, high sensibility and inhibition to show overt aggressive behaviour, which is suppressed by guilt feelings. These findings are used to develop a first idealtypic psychopathogenetic model of sudden deafness. Detecting and talking about the individual psychosocial strain of the patient is very important in the management of the disease and the social-medicine assessments, especially in determining duration of disablement and estimating grade of disability (GdB) in the case of persistent decrease of hearing and tinnitus.
