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Sudden sensorineural hearing loss in adults — Our experience with a multidrug high-dose steroid regimen at a tertiary care hospital
The Egyptian Journal of Otolaryngology volume 32, pages105–109(2016)
Sudden sensorineural hearing loss is a confusing and controversial issue in our practice since no standard definition, evaluation method and treatment protocol exists. It is more a symptom than a disease entity. It is an otological emergency with narrow golden period of treatment.
To establish the early diagnosis, treatment and study the outcome of treatment.
Design and method
It is a prospective study, including patients >18 year age who had presented with sudden sensorineural hearing loss in ENT opd. Patients underwent general systemic and ENT examination, pure tone audiometry, impedance audiometry and necessary imaging. After diagnosis patients were treated with i.v. methylprednisolone 2 gm loading dose on day 1 followed by 1 gm BD for 2 days. and then tab. Prednisolone (1 mg/kg/day) for 5 days, gradually tapered over next 10 days along with tab. pentoxyfylline 400 mg TDS for 14 days with inj. methylcobalamine i.m. OD for 3 days. Pure tone audiogram was repeated on 4th day, 3 week, and 6 weeks after diagnosis.
The study group included 37 patients who were diagnosed and treated. 56.76% of patients had sudden SNHL of < 72 hrs. duration, while 43.24% had sudden SNHL of >72 hrs. duration. The majority i.e. 35.14% had severe hearing loss (71-90 db) followed by 29.73% with moderate hearing loss (41-55 db). Tinnitus was noted as commonest associated symptom in 78.38% followed by tinnitus & vertigo in 21.62%. As per etiology, idiopathic cause (64.86%) was followed by acoustic trauma (24.32%) and head trauma (10.81%) in study group. In terms of recovery, 35.14% patients had complete recovery while 40.54% and 24.32% patients had partial and no recovery respectively.
The diagnosis of sudden SNHL is easily obtained by audiometry. Exact etiology often remains unknown so early diagnosis by avoiding unnecessary investigations and prompt treatment in <72 hrs. still carry good prognosis.
National Institute of Health. Sudden deafness. Bethesda: National Institutes of Health, 2000. NIH publication 00-4757. Available at: http://www.nidcd.nih.gov/health/hearing/sudden.asp. [Last Accessed on 2009 May 19].
Nagaoka J, Anjos MF, Takata TT, Chaim RM, Barros F, Penido Nde O. Idiopathic sudden sensorineural hearing loss: evolution in the presence of hypertension, diabetes mellitus and dyslipidemias. Braz J Otorhinolaryngol 2010; 76: 363–369.
Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double- blind clinical study. Arch Otolaryngol 1980; 106: 772–776.
Byl FMJr. Sudden hearing loss: eight years experience and suggested prognostic table. Laryngoscope 1984; 94:647–661.
Charles W. Cummings otolaryngology head & neck surgery. 4th ed. Philadelphia: Elsevier; 2005. 3554.
O’Malley MR Hayens DS. Sudden hearing loss. Otolaryngology Clin North Am 2008; 41:633–649.
Vijayendra H, Buggaveeti G, Parikh B, Sangitha R. Sudden sensorineural hearing loss: an otologic emergency. Indian J Otolaryngol Head Neck Surg 2012; 64: 1–4.
Bullo F, Tzamtzis S, Tirelli G. Update on the sudden hearing loss. Indian J Otol 2013; 19: 95–99.
Cvorovic L, Deric D, Probdt R, Hegemann S. Prognosticmodel for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurotol 2008; 29: 464–469.
Nakashima T, Tanabe T, Yanagita N, Wakai K, Ohno Y. Risk factors for sudden deafness: a case control study. Auris Nasus Larynx. 1997; 24:265–270.
Pajor A, Durko T, Gryczynski M. Predictive value of factors influencing recovery from sudden sensorineural hearing loss. Int Congress Series 2003; 1240: 287–290.
Mattox DE, Lyles CA. Idiopathic sudden sensorineural hearing loss. Am J Otol 1989; 10: 242–247.
Plaza G, Durio E, Herraiz C, Rivera T, Garcia-Berrocal JR, Asociación Madrileña de ORL Consensus on diagnosis and treatment of sudden hearing loss. Acta Otorrinolaringol Esp 2011; 62: 144–157.
Hirano K, Ikeda K, Kawase T, et al. Prognosis of sudden deafness with special reference to risk factors of microvascular pathology. Auris Nasus Larynx 1999; 26: 111–115.
Li Lin SW, Lin YS, Weng SF, Chou CW. Risk of developing sudden sensorineural hearing loss in diabetic patients: a population based cohort study. Otol Neurotol 2012; 33:1482–1488.
Fetterman BL, Saunders JE, Luxford WM. Prognosis and treatment of sudden sensorineural hearing loss. Amj otol 1996; 17: 529–536.
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Gupta, V., Jain, A., Banerjee, P.K. et al. Sudden sensorineural hearing loss in adults — Our experience with a multidrug high-dose steroid regimen at a tertiary care hospital. Egypt J Otolaryngol 32, 105–109 (2016). https://doi.org/10.4103/1012-5574.181085
- pure tone audiogram
- sudden sensorineural hearing loss