INTRODUCTION
Sudden onset sensorineural hearing loss (SSNHL) is defined as a 30
decibel(dB) loss in three consecutive frequencies occurring over less
than 72 hours. It is most commonly idiopathic in nature, although there
are numerous suggested aetiologies including immune, vascular and
infective causes.1 Current guidelines suggest treating
such patients with oral or intratympanic steroid therapies.
The American Academy of Otolaryngology Head and Neck Surgery, USA,
published guidelines for the investigation, management and follow-up of
patients presenting with SSNHL in Aug 2012.2Furthermore, they have recently published an update to this original
guidance in 2019.3 ENT-UK have also recently published
guidance on this area.4 It is suggested, through these
guidelines and the literature, that patients should initially be treated
with a course of oral steroids following SSNHL. This is typically 1mg/kg
(Max 60mg) for 7 days, followed by a tapering dose for a further 7 days.
The American Academy guidelines recommend that patients should be
offered salvage intratympanic steroids (ITS) for patients who have
incomplete recovery from SSNHL. ENT-UK guidance states that if there is
no improvement from oral steroids after 7-14 days to consider salvage
ITS therapy.
As a direct result of the American Academy guidelines, [removed for
blind peer review] ENT department instigated salvage ITS therapy. This
study follows the results of this treatment, in a real-world scenario
within a busy teaching hospital, to provide a UK perspective on the
benefits of this regime. We hope this will educate other departments as
to how we instigated this service, and of the initial results obtained.