Management of sudden sensorineural hearing loss: a consultant survey (original) (raw)

Sudden sensorineural hearing loss: A missed opportunity for treatment

PubMed, 2018

Sudden sensorineural hearing loss (SSNHL) is an otology emergency and carries significant morbidity if the diagnosis is missed. It can present to any specialty but in our local setting the patient usually presents to primary care as it is easily accessible. We present a case of SSNHL that was initially presented to a primary care centre and the patient was reassured without any investigation being carried out. SSNHL has many causes thus making diagnosis difficult. However, with knowledge of its possible, a diagnosis can be made and appropriate management can be advocated to the patient. Hence, we discuss the three main causes of SSNHL, while emphasizing the immune system-mediated mechanism as the main cause in this case.

Sudden Hearing Loss: Ten Years' Treatment Experience

2007

Objective: Determine the follow-up between pacients sudden sensorineural hearing loss (SSHL) treated in five different groups according to duration of disease and the drugs used for treatment. Study design: Retrospective cohort study. Method: Review of patients records included in a standardized protocol of treatment of the SSHL Outpatient unit between January 1996 and January 2006. Inclusion criteria were SSHL occurring within 72 hours and 30 dB or more at three serial frequencies. Pacients were included in five treatment groups and had received Dextran ® , dexamethasone, acyclovir, nicotinic acid, papaverine chloridrate and or vitamin A. Audiometric assessment was done before and after treatment (30, 90, 120 and 180 days). Outcome was determined by subtracting baseline PTA (first day of the medical assessment) from final PTA (after 180 days). Results: Complete data were collected for 139 subjects, mean age were 45,4 years, 52,5% were female and 47,5% were male, 92,8% had unilateral SSHL and 7,2% had bilateral one. PTA mean before treatment were similar between groups. Treatment significantly improved PTA mean after 180 days. Nevertheless, no significant difference could be noted in audiometric assessment between treatment groups. We observed a significant linear correlation between time from SSHL onset to initial visit and audiometric recovery. Conclusion: Dextran ® did not provide more benefit than steroid and acyclovir in the treatment of SSHL. As soon as treatment begins better will be the outcome prognosis for SSHL.

Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss

Acta otorrinolaringologica espanola, 2018

Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss. To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL. After a systematic review of the literature from 1966 to March 2018, on MESH terms «(acute or sudden) hearing loss or deafness», a third update was performed, including 1508 relevant papers. Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and th...

Sudden Sensorineural Hearing Loss: An Updated Review

Acta Scientific Otolaryngology, 2021

Sudden sensorineural deafness is defined as a hearing loss greater than 30 dB in 3 contiguous frequencies of pure tones that occur within 72 hours. It is a rare but disabling entity, affecting approximately 5-27 people per 100,000 globally per year. The etiology is identified only in a few cases, being a viral infection the most associated cause. The diagnosis is based primarily on the medical history, physical examination, and pure tone audiometry. The mainstay of treatment is corticosteroids, either systemic or intratympanic. This treatment can be accompanied by hyperbaric oxygen therapy to improve the response. For the follow-up, serial audiometric studies are suggested at the end of the treatment and six months, in search of residual hearing loss. We examined the most recent studies on epidemiology, clinical manifestations, diagnosis, and treatment of sudden sensorineural hearing loss to provide a comprehensive review on this topic to improve the understanding of this entity among clinicians.

A critical analysis of the management protocols for idiopathic sudden sensori-neural hearing loss

Journal of Ayub Medical College, Abbottabad : JAMC

Sudden sensori-neural hearing loss (SSNHL) is a clinical dilemma with great diversity in presentation and poorly understood pathogenesis and hence no definitive treatment protocol as yet. Both sexes are affected, middle age to elderly being the commonest age group. A variety of causes have been implicated as responsible for this condition, but most of the times it is difficult to isolate one, and hence most of the times a battery of investigations proves to be a clinical exercise. A number of treatment protocols have been suggested and used over the years, based on presumed etiological theories, claiming varying degrees of success. Relevant literature available on the net regarding the management and the efficacy of various treatment regimens for ISSNHL was critically analyzed by the authors (who are professorial staff of a medical college and consultants of a teaching hospital) to develop a consensus and recommendations on the most appropriate protocol. It was asserted that various...

Sudden Sensorineural Hearing Loss: Comparative Study of Different Treatment Modalities

International Archives of Otorhinolaryngology, 2017

Introduction Idiopathic sudden sensorineural hearing loss (ISSNHL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many different modalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances. Objectives This study aims to evaluate the efficacy of the combination of the most common treatment modalities of ISSNHL and to compare the results if HOT was not one of the treatment modalities administered. Methods The study was conducted with 22 ISSNHL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT. Results After one...

Sudden hearing loss: a ten-year outpatient experience

The international tinnitus journal, 2009

The aim of this study was to determine the effects of various treatment modalities employed for patients with sudden sensorineural hearing loss (SHL). We retrospectively evaluated the records of patients treated in the sudden hearing loss section of the Otolaryngology Department at Clinic Hospital, School of Medicine, University of São Paulo, Brazil, between 1996 and 2006. Our study included patients with SHL of sudden onset (occurring over a 72-hour period) at equal to or greater than 30 dB at three consecutive frequencies. We divided patients into five groups by profile and treated them with dextran, dexamethasone, acyclovir, nicotinic acid, and papaverine hydrochloride (with or without vitamin A). We performed audiometry at baseline and on days 30, 90, 120, and 180 of treatment. We determined outcome as the difference between day-0 and day-180 pure-tone averages (PTAs). Among the 139 patients evaluated, baseline PTA was similar in all groups. We observed significant improvements ...

Clinical Practice Guideline: Sudden Hearing Loss (Update)

Otolaryngology-Head and Neck Surgery, 2019

Objective. Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently but not universally accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged 18 years and primarily on those with idiopathic sudden sensorineural hearing loss. Prompt recognition and management of sudden sensorineural hearing loss may improve hearing recovery and patient quality of life. The guideline update is intended for all clinicians who diagnose or manage adult patients who present with sudden hearing loss.