Sudden Sensorineural Hearing Loss

Question 1

What is Sudden Sensorineural Hearing Loss?

Answer 1

• This is defined as hearing loss less than 72 hours

Question 2

How serious is Sudden Sensorineural Hearing Loss?

Answer 2

• This is an otological emergency
• Requires immediate referral to the on- call ENT team

Question 3

Is SSHL typically unilateral or bilateral?

Answer 3

• Often Unilateral

Question 4

What are conductive causes of Rapid- onset Hearing Loss?

Answer 4

• Ear wax
• Infection
• Fluid in the middle ear (effusion)
• Eustachian tube dysfunction
• Perforated tympanic membrane

Question 5

What are the causes of SSHL?

Answer 5

• Most are idiopathic
• Infection (Meningitis, HIV and Mumps)
• Meiniere’s disease
• Ototoxic medications
• Multiple Sclerosis
• Migraine
• Stroke
• Acoustic Neuroma
• Cogan’s Syndrome (rare autoimmune condition causing inflammation of the eyes and the inner ear)

Question 6

What investigations are used for SSHL?

Answer 6

• Audiometry - requires a loss of at least 30 decibels in three consecutive frequencies on the audiogram
• MRI or CT head (if stroke or acoustic neuroma if being considered)

Question 7

What is the managment for SSHL?

Answer 7

• Immediate referral to ENT for an assessment within 24 hours
• High Dose oral corticosteroids are used by ENT for all cases of SSNHL
• Idiopathic SSHL - treated with steroids (1. Oral 2. Intra-tympanic)