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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).
1
2
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
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Intratympanic corticosteroids
Cochlear implants