Sudden Hearing Loss
Sudden hearing loss can be frightening for patients and often they will visit their family physician for diagnosis and treatment. Sudden hearing loss is a rapid onset of hearing loss in one or both ears that occurs within a 72-hour period. It is a decrease in hearing of 30 dB or more at 3 consecutive frequencies. In 85-90% of cases the etiology of sudden hearing loss is unknown and referred to as idiopathic sudden sensorineural hearing loss (ISSNHL).
In March of 2012, new clinical practice guidelines for sudden hearing loss were established by the American Academy of Otolaryngology – Head and Neck Surgery Foundation. They established 13 evidence-based action statements for diagnosis, management and follow-up of sudden hearing loss.
Highlights from the guidelines:
- Rule out conductive hearing loss
- Assess for neurologic findings, bilateral sudden hearing loss or recurrent episodes of sudden hearing loss
- Do not order CT in the initial work up
- Confirm ISSHL with audiometry
- Do not order routine lab test for initial work up
- Retrocochlear pathology should be investigated by MRI, ABR and/or audiometric follow-up
- Patients should be educated on ISSHL, risks, benefits and limitations of intervention
- Corticosteroids offered as the initial therapy
- Hyperbaric oxygen therapy may be used within 3 months of diagnosis
- Other pharmacologic therapy should not be routinely used in ISSHL
- Intratympanic steroid therapy can be used as salvage therapy for those with incomplete recovery
- Follow-up audiogram should be obtained at 6 months to assess outcomes
- Counselling on rehabilitation including the use of hearing aids and assistive listening devices for individuals with incomplete recovery
More information on the current guidelines – http://www.ncbi.nlm.nih.gov/pubmed/22383545
Sudden hearing loss is considered a medical emergency. If one of your patients has a sudden hearing loss we will accommodate them in one of our 6 clinics the same day. Please call for more information 902-482-2222.
