Sudden Onset Sensorineural Hearing Loss

Question 1

Are the majority of cases idiopathic?

Answer 1

Yes - 85%

URTI related viral infections and microvascular obstruction to blood flow in cochlear being potential underlying causes

Question 2

Is it an emergency?

Answer 2

Yes and requires urgent referral to ENT for audiology assessment and brain MRI

Question 3

What are used by ENT as management?

Answer 3

High dose oral corticosteroids

Question 4

What criteria established by NICE, require immediate referral to ENT/emergency department?

Answer 4

Sudden onset <3 days of unilateral or bilateral hearing loss which cannot be explained by external or middle ear causes
Unilateral hearing loss associated with focal neurology - altered sensation or facial droop
Hearing loss associated with head or neck injury
Hearing loss associated with severe infection e.g Ramsay Hunt syndrome or necrotising OE

Question 5

What are rarer causes?

Answer 5

Vestibular schwannoma or other intracranial tumour
Trauma, blasts and loud noise 
Barotrauma
Meningitis
Herpes zoster, syphilis
MS
Stroke