Sudden sensorineural hearing loss (SSNHL) is defined as an unexplained rapid decline in the hearing of at least 30 decibels (dB) affecting three or more frequencies over 3 days. The reported incidence is 5 - 20 persons per 100,000 per year. The vast majority of cases are idiopathic with only 10% of patients having a specific attributable cause diagnosed.
Average age of presentation is between 40-50 years with equal sex incidence. Hearing loss maybe partial or complete and is often accompanied by tinnitus.
Investigations are targeted at excluding the known causes of SSNHL. Treatment Oral steroids are the gold standard treatment for this condition; however many other treatment strategies have been used including: intratympanic steroids, antiviral agents, carbogen, hyperbaric oxygen, and magnesium supplementation. The prognosis of SSNHL is good with the majority of patients improving within the first two weeks after the hearing loss.
Sudden sensorineural hearing loss is an otologic emergency. The majority of patients will have no identifiable cause. However, prompt treatment with oral steroids is associated with a better recovery. Emerging data has shown that intratympanic dexamethasone is at least as effective as oral steroid treatment and the addition of other agents such as carbogen and magnesium may also have a role to play in the management of this enigmatic condition.