ENT - Sudden SN Hearing Loss

Question 1

What is sudden sensorineural hearing loss (SSNHL)?

Answer 1

Hearing loss over less than 72 hours, unexplained by other causes

Otological emergency- immediate referral to ENT

Diagnosis made when someone rapidly loses hearing and no conductive cause found

Question 2

What is the most common characteristic of hearing loss in SSNHL?

Answer 2

Most often unilateral

Can be permanent or resolve over days to weeks

Question 3

What are some conductive causes of rapid-onset hearing loss that are not classed as SSNHL?

Answer 3

• Ear wax (or blockage)
• Infection (e.g., otitis media or externa)
• Fluid in the middle ear (effusion)
• Eustachian tube dysfunction
• Perforated tympanic membrane

Question 4

What percentage of SSNHL cases are idiopathic?

Answer 4

90%.

Question 5

List some other causes of SSNHL

Answer 5

• Infection (e.g., meningitis, HIV, mumps)
• Ménière’s disease
• Ototoxic medications
• Multiple sclerosis
• Migraine
• Stroke
• Acoustic neuroma
• Cogan’s syndrome

Cogan’s syndrome is a rare autoimmune condition causing inflammation of the eyes and inner ear

Question 6

What investigation is required to establish the diagnosis of SSNHL?

Answer 6

Audiometry

Diagnosis needs loss of at least 30 dB in three consecutive frequences on an audiogram

Question 7

What imaging studies may be used if considering a stroke or acoustic neuroma?

Answer 7

MRI or CT head

Used to help rule out more serious causes

Question 8

What is the NICE recommendation for managing SSNHL?

Answer 8

Immediate referral to ENT for assessment within 24 hours

For patients presenting within 30 days of onset

Question 9

How may idiopathic SSNHL be treated?

Answer 9

Steroids by ENT
- Oral
- Intra-tympanic, via injection through TM