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Sudden Sensorineural Hearing LossAka: SSHNL

Presentation
1. Rapid loss of hearing over a 3 day period
2. Hearing Loss of 30 DB in at least 3 connected frequencies
Prognosis
1. Spontaneous recovery in 65% of idiopathic cases
Causes
1. Multiple
2. Most common causes
  1. Viral infection
  2. Vascular event
  3. Autoimmune process
Evaluation
1. Urgent Audiogram (same day) to confirm Sensorineural Hearing Loss
Imaging (if SSHNL confirmed by Audiogram)
1. MRI with gadolinium
  1. Evaluates retrocochlear lesion
Management
1. Sudden Sensorineural Hearing Loss requires immediate evaluation
  1. Otolaryngology evaluation is recommended within 24 hours
2. Consider antiviral medications
  1. Ten days of Valacyclovir, Famciclovir, or Acyclovir
3. Corticosteroids
  1. Corticosteroids orally
    1. Typical adult dose: 60 mg for 5 days and then taper off over next 5 days
  2. Intratympanic Corticosteroids by Otolaryngology
4. Other measures used
  1. Hyperbaric oxygen
  2. Diuretics
  3. Plasma expanders
References
1. Browning (2008) Park Nicollet Primary Care Update, Lecture, St. Louis Park, MN

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This page was written by Scott Moses, MD. This page was last revised on 11/21/2008 8:49:41 AM. This page was last published on 8/14/2009. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.