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Sudden sensorineural hearing loss

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of sudden sensorineural hearing loss are prepared by our editorial team based on guidelines from the American Cochlear Implant Alliance (ACI Alliance 2022) and the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF 2019). ...
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Diagnostic investigations

History and physical examination
As per AAO-HNSF 2019 guidelines:
Distinguish sensorineural hearing loss from conductive hearing loss when a patient first presents with sudden hearing loss.
B
Assess patients with presumptive SSNHL through history and physical examination for bilateral sudden hearing loss, recurrent episodes of sudden hearing loss, and/or focal neurologic findings.
B
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  • Audiometry

  • Laboratory testing

  • CT

  • MRI and auditory brainstem response

Medical management

Systemic corticosteroids: as per AAO-HNSF 2019 guidelines, consider systemic corticosteroids as first-line therapy for patients with SSNHL within 2 weeks of symptom onset.
C

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  • Other medications

Therapeutic procedures

Hyperbaric oxygen therapy
As per AAO-HNSF 2019 guidelines:
Consider offering, or referring to a clinician who can offer, hyperbaric oxygen therapy combined with corticosteroid therapy within 2 weeks of onset of SSNHL.
C
Consider offering, or referring to a clinician who can offer, hyperbaric oxygen therapy combined with corticosteroid therapy as salvage within 1 month of onset of SSNHL.
C

More topics in this section

  • Intratympanic corticosteroids

  • Cochlear implants

Patient education

Patient education: as per AAO-HNSF 2019 guidelines, educate patients with SSNHL about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy.
B

Follow-up and surveillance

Follow-up: as per AAO-HNSF 2019 guidelines, arrange follow-up audiometric evaluation for patients with SSNHL at the conclusion of treatment and within 6 months of completion of treatment.
B

More topics in this section

  • Audiologic rehabilitation