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sudden sensorineural hearing loss
Etiology:
- viral infection
- drug reaction
- acoustic neuroma
- multiple sclerosis
- head injury
- vascular disease
- autoimmune disease
- Meniere's disease
- idiopathic 90%
Clinical manifestations:
- unilateral tinnitus
- ear fullness
- vertigo less frequent
Special laboratory:
- audiometry
Radiology:
- MRI neuroimaging to exclude tumor, multiple sclerosis, vascular disease
Management:
- refer to otolaryngologist
- glucocorticoids (evidence lacking) [1,2]
- ref [3] NEJM) claims high-dose oral prednisone effective if initiated within 7-10 days
- intravenous prednisolone 250 mg or oral dexamethasone 40 mg for 5 days no more effective than prednisone 60 mg for 5 days followed by 5 day taper [4]
General
sensorineural hearing loss
References
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018
- Wei BP, Stathopoulos D, O'Leary S.
Steroids for idiopathic sudden sensorineural hearing loss.
Cochrane Database Syst Rev. 2013 Jul 2;2013(7):CD003998.
PMID: 23818120 PMCID: PMC7390468 Free PMC article
- NEJM Knowledge+ Otolaryngology
- Plontke SK et al.
High-dose glucocorticoids for the treatment of sudden hearing loss.
NEJM Evid 2024 Jan; 3:EVIDoa2300172.
PMID: 38320514 Clinical Trial.
https://evidence.nejm.org/doi/10.1056/EVIDoa2300172