Sudden sensorineural hearing loss is usually unilateral and can be associated with tinnitus and vertigo, according to The Lancet article authored by Benjamin E Schreiber MRCP, Charlotte Agrup PhD, Professor Dorian O Haskard FMedSci, and Professor Linda M Luxon FRCP.

In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed, they note, adding that a careful examination is needed to exclude life-threatening or treatable causes such as vascular events and malignant diseases, and patients should be referred urgently for further assessment. About half of patients completely recover, usually in about 2 weeks. Many treatments are used, including corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments. Although no treatment is proven, the authors recommend a short course of oral high-dose corticosteroids. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.

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The authors concluded that patients with sudden hearing loss presenting to general practice should be assessed with a minimum of pure tone audiometry (with air and bone conduction thresholds), and those with sensorineural hearing loss should be urgently referred to a specialist.

The authors searched the Medline, Embase, and Cochrane databases for relevant studies, including basic science reports; case reports; retrospective, prospective, and cohort studies; and randomized controlled trials published between January, 1989, and October, 2009, in any language. They also searched the reference lists of articles identified by the search strategy, and largely focused on publications in the past 5 years, but have included commonly referenced and highly regarded older publications.

HR published a special edition on sudden sensorineural hearing loss guest-edited by Maurice H. Miller, PhD, in the December 2003 edition.

[Source: The Lancet]