Clinical Practice Guideline: Sudden Hearing Loss

This plain language summary explains sudden hearing loss (SHL) to patients and focuses on sudden sensorineural (pronounced sen-suh-ree-noo r-uh l) hearing loss (SSNHL). The summary is for adult patients aged 18 and over and is based on the 2019 “Clinical Practice Guideline: Sudden Hearing Loss (Update).” The guideline uses research to advise doctors and other health care providers on the proper testing and treatment of patients with SSNHL. The guideline includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to help patients ask questions and make decisions in their own care.

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Evaluation of Compliance for Treatment of Sudden Hearing Loss

Otolaryngology ◽

10.1177/0194599816650175 ◽

2016 ◽

Vol 155 (1) ◽

pp. 48-55 ◽

Cited By ~ 14

Author(s):

David L. Witsell ◽

Tawfiq Khoury ◽

Kristine A. Schulz ◽

Robert Stachler ◽

Debara L. Tucci ◽

...

Keyword(s):

Hearing Loss ◽

Clinical Practice ◽

American Academy ◽

Head And Neck ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Neck Surgery ◽

Sudden Hearing Loss ◽

Head And Neck Surgery ◽

Community Based

Objective The objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community-based practices within the context of the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s “Clinical Practice Guideline: Sudden Hearing Loss.” The intention is to use these findings to guide implementation strategies and quality improvement initiatives and as pilot data for the development of clinical research initiatives. Study Design A cross-sectional study of patients with sudden hearing loss. Setting Patients were recruited from practices within the Creating Healthcare Excellence through Education and Research (CHEER) network. The CHEER network is an National Institutes of Health–funded network of 30 otolaryngology sites across the country, half of which are community based and half of which are academic practices. Subjects and Methods A total of 173 patients were recruited. Data were gathered via custom questionnaires collected by study site coordinators and entered into a secure online platform. Descriptive analyses and correlation statistics were run with SAS 9.3.1. Results Of the 13 guideline statements in the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s clinical practice guideline on sudden hearing loss, 11 statements were evaluable through this study. Compliance for otolaryngologists was >95% for key action statements (KASs) 1, 3, and 6; 90% to 95% for KASs 5 and 10; and <90% for KASs 7 and 13. Compliance was <45% for nonotolaryngologists for KASs 3 and 5-7. Conclusions There is opportunity for nonotolaryngologists to improve for statements 3 and 5-7. Otolaryngologists are compliant with many of the KASs overall, but there is significant room for improvement.

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Clinical Practice Guideline: Ménière’s Disease Executive Summary

Otolaryngology ◽

10.1177/0194599820909439 ◽

2020 ◽

Vol 162 (4) ◽

pp. 415-434 ◽

Cited By ~ 5

Author(s):

Gregory J. Basura ◽

Meredith E. Adams ◽

Ashkan Monfared ◽

Seth R. Schwartz ◽

Patrick J. Antonelli ◽

...

Keyword(s):

Hearing Loss ◽

Clinical Practice ◽

Sensorineural Hearing Loss ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Meniere’S Disease ◽

Sensorineural Hearing ◽

Ménière’S Disease ◽

Ménière's Disease

Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many, and approaches typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

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Clinical Practice Guideline: Ménière’s Disease

Otolaryngology ◽

10.1177/0194599820909438 ◽

2020 ◽

Vol 162 (2_suppl) ◽

pp. S1-S55 ◽

Cited By ~ 5

Author(s):

Gregory J. Basura ◽

Meredith E. Adams ◽

Ashkan Monfared ◽

Seth R. Schwartz ◽

Patrick J. Antonelli ◽

...

Keyword(s):

Hearing Loss ◽

Clinical Practice ◽

Sensorineural Hearing Loss ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Meniere’S Disease ◽

Sensorineural Hearing ◽

Ménière’S Disease ◽

Ménière's Disease

Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Conventional imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many and typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

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Quality Improvement in Otolaryngology–Head and Neck Surgery: Age-Related Hearing Loss Measures

Otolaryngology ◽

10.1177/01945998211000442 ◽

2021 ◽

pp. 019459982110004

Author(s):

Richard K. Gurgel ◽

Selena E. Briggs ◽

Nui Dhepyasuwan ◽

Richard M. Rosenfeld

Keyword(s):

Hearing Loss ◽

Clinical Practice ◽

Head And Neck ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Neck Surgery ◽

Diagnosis And Treatment ◽

Evidence Based ◽

Age Related ◽

Age Related Hearing Loss

Background and Significance There is a high and growing prevalence of age-related hearing loss (ARHL), defined as presbycusis or bilateral, symmetric sensorineural hearing loss in older adults. Due to the increasing prevalence of ARHL, the potential delays in its diagnosis and treatment, and the significant disability associated with ARHL, the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) convened a Measures Development Group (MDG) to develop quality measures (QMs) of clinical practice that could be incorporated into the AAO-HNSF’s data registry Reg-ent. Although the AAO-HNSF has been engaged in robust clinical practice guideline development since 2006, the development of quality and performance measures is more recent. Methods We report the process, experience, and outcomes in developing a de novo QM set for ARHL in the absence of a preexisting clinical practice guideline on this topic. Steps include the MDG review of evidentiary literature on ARHL, followed by stakeholder discussions to develop measure specifications. Key considerations included discussion on the relative importance, usability, and feasibility of each measure within the Reg-ent or similar databases. Results The MDG created 4 QMs for the diagnosis and treatment of AHRL. These measures represent the AAO-HNSF’s quality initiatives to develop evidence-based QMs and improve patient care and outcomes, and they are intended to assist providers in enhancing quality of care. Conclusion Development of the ARHL measures is intended for clinicians to evaluate the patient perception, structure, process, and outcomes of care. This process represents a new stage in the AAO-HNSF’s measure development efforts to facilitate future efforts in evidence-based QM.

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