Sudden Sensorineural Hearing Loss

Question 1

Sudden Sensorineural Hearing Loss

Answer 1

Rapid hearing loss within 72 hours

Not explained by other causes and not conductive

Otological emergency -immediate referral to the on-call ENT team

Question 2

Presentation of sudden sensorineural hearing loss

Answer 2

Often unilateral

May be permanent or resolve over days to weeks

Question 3

Causes of SSNHL

Answer 3

90% - idiopathic

Infection - meningitis, HIV and mumps

Ménière’s disease

Ototoxic medications

Multiple sclerosis

Migraine

Stroke

Acoustic neuroma

Cogan’s syndrome

Question 4

Cogan’s syndrome

Answer 4

Rare autoimmune condition causing inflammation of the eyes and inner ear

Question 5

Investigations of SSNHL

Answer 5

Audiometry - loss of at least 30 decibels in three consecutive frequencies

MRI or CT head may be used if a stroke or acoustic neuroma are being considered

Question 6

Management of SSNHL

Answer 6

Immediate referral to ENT for assessment within 24 hours if presenting within 30 days of onset

Treat underlying cause

Idiopathic SSNHL may be treated with steroids under ENT guidance:

• Oral
• Intra-tympanic (via an injection of steroids through the tympanic membrane)