scholarly journals Management of sudden sensorineural hearing loss among primary care physicians in Canada: a survey study

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Benjamin Ng ◽  
Matthew G. Crowson ◽  
Vincent Lin
Keyword(s):  
Primary Care ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Primary Care Physicians ◽  
Tuning Fork ◽  
Family Physicians ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Medical Emergency

Abstract Background Sudden Sensorineural Hearing Loss (SSNHL) is a medical emergency requiring immediate attention as delayed treatment can lead to permanent and devastating consequences. Primary care physicians are likely the first to be presented with SSNHL and therefore have the crucial role of recognizing it and initiating timely and appropriate management. The aim of this study was to gain insight into the current knowledge and practice trends pertaining to the diagnosis and management of SSNHL among family physicians in Canada. Methods An 18-question survey targeting Canadian family physicians was marketed through two, physician-only discussion groups on the social media platform Facebook. Responses were collected between August 1st and December 22nd 2019 then aggregated and quantified. Results 52 family physicians submitted responses. 94.2% (n = 49) reported that in their practice, unilateral SSNHL warrants urgent referral to otolaryngology and 84.6% (n = 44) reported that unilateral sudden-onset hearing loss warrants urgent referral for audiological testing. 73.1% of participants (n = 38) reported that they would attempt to differentiate between conductive and sensorineural hearing loss if presented with unilateral, acute or sudden-onset hearing loss. 61.5% (n = 32) would rely on tuning fork tests to inform management decisions, as compared to 94.2% (n = 49) relying on case history and 88.5% (n = 46) on otoscopy. 76.9% (n = 40) would prescribe corticosteroids if presented with confirmed, unilateral SSNHL. Conclusion The majority of family physicians in the study would make appropriate referral and treatment decisions in the management of SSNHL, understanding it is a medical emergency. Tuning fork tests are under-utilized for informing management decisions compared to other means of differentiating conductive and sensorineural hearing loss. Further research is needed to understand why some family physicians do not prescribe corticosteroids for treatment of SSNHL, which may then identify any gaps in knowledge or inform improvements in clinical protocol. Graphical abstract

Practice Guidelines for Sudden Sensorineural Hearing Loss

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P58-P58
Author(s):  
David Richard Friedland ◽  
Nima L. Shemirani
Keyword(s):  
Primary Care ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Treatment Protocols ◽  
Oral Steroids ◽  
Management Approaches

Objective To identify and compare patterns of treatment for sudden sensorineural hearing loss among otolaryngologists and primary care physicians. Methods A multiple choice and Likert scale survey was mailed to 1,306 otolaryngologists and primary care physicians throughout our state, regarding treatment and management approaches to SSNHL. Survey answers were analyzed by scope of practice and years of experience. Treatment protocols were compared among family practitioners, internists, general otolaryngologists, and otologists. Results A surprisingly large number of general practitioners treat SSNHL independent of an otolaryngologist. General practitioners as a group, however, are significantly less impressed than otolaryngologists that steroids are an effective treatment (p<0.0001). Over 99% of otolaryngologists start oral steroids at evaluation, as compared to approximately 30% of all general practitioners. Of those general practitioners treating on their own, without otolaryngology consultation, 78% use oral steroids. The vast majority of otolaryngologists start therapy with at least 60 mg of prednisone, while lower doses and Medrol dose packs are more commonly used by general practitioners. Otolaryngologists are more likely to treat with steroids beyond 1 week of hearing loss onset, while general practitioners overwhelmingly will only treat within the first week. Over 50% of otolaryngologists also add anti-viral medications. Conclusions Significant differences exist in the management of SSNHL between otolaryngologists and general practitioners. The lack of strong evidence-based guidelines for the treatment of SSNHL may underlie the variability in management by first-line providers.

Trough-Shaped Audiograms Are Common in Patients with Acoustic Neuroma and Sudden Sensorineural Hearing Loss

2018 ◽  
Vol 23 (1) ◽  
pp. 58-62
Author(s):  
Kumiko Hosokawa ◽  
Seiji Hosokawa ◽  
Satoru Takebayashi ◽  
Hiroyuki Mineta
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Acoustic Neuroma ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Significant Finding ◽  
Frequency Range

Acoustic neuroma sometimes presents with sudden-onset sensorineural hearing loss as a primary symptom. We investigated 848 untreated cases that included 20 cases with acoustic neuroma with sudden-onset sensorineural hearing loss and 828 cases without acoustic neuroma. Fourteen of the 20 acoustic neuroma and 90 of the 828 cases of sudden-onset sensorineural hearing loss showed a trough-shaped audiogram with the greatest amount of hearing loss in the mid-frequency range. The incidence of a trough-shaped audiogram was significantly higher in patients with acoustic neuroma than in those without (p < 0.01). This study suggests that a trough audiogram is a significant finding in patients with sudden-onset sensorineural hearing loss and indicates the presence of acoustic neuroma.

scholarly journals Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss—A Retrospective Study

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 96
Author(s):  
Magdalena B. Skarżyńska ◽  
Aleksandra Kołodziejak ◽  
Elżbieta Gos ◽  
Milaine Dominici Sanfis ◽  
Piotr H. Skarżyński
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Success Rate ◽  
Complete Recovery ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Prolonged Treatment ◽  
Retrospective Clinical Study ◽  
Hearing Recovery

(1) Background: A retrospective clinical study was conducted to compare the effectiveness of different pharmacological and non-pharmacological regimens for treating sudden sensorineural hearing loss (SSNHL). (2) Methods: Adult patients (n = 130) diagnosed with sudden sensorineural hearing loss (SSNHL) and hospitalized between 2015 and 2020 were enrolled in this study. Depending on the treatment regimen applied, patients were divided into five groups. Inclusion criteria were as follows: (i) hearing loss of sudden onset; (ii) hearing loss of at least 30 dB at three consecutive frequencies; (iii) unilateral hearing loss; (iv) age above 18 years. Exclusion criteria were as follows: (i) no follow-up audiogram; (ii) bilateral hearing loss; (iii) recognized alternative diagnosis such as tumor, disorder of inner ear fluids, infection or inflammation, autoimmune disease, malformation, hematological disease, dialysis-dependent renal failure, postdural puncture syndrome, gene-related syndrome, mitochondrial disease; and (iv) age below 18 years. (3) Results: Complete recovery was found in 14% of patients (18/130) and marked improvement was found in 6% (8/130), giving an overall success rate of 20%. The best results were obtained in the second group (i.e., patients given intratympanic glucocorticoid + prolonged orally administered glucocorticoid) where the success rate was 28%. In general, the older the patient, the smaller the improvement in hearing, a correlation that was statistically significant. (4) Conclusions: In treating SSNHL, the highest rate of hearing recovery—28%—was in the group of patients given intratympanic corticoid plus prolonged treatment with orally administered glucocorticoid.

Unilateral sudden hearing loss as the first presenting symptom of moyamoya disease

2013 ◽  
Vol 127 (2) ◽  
pp. 196-199 ◽  
Author(s):  
L-S Tseng ◽  
S-D Luo
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Moyamoya Disease ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Internal Carotid Arteries

AbstractObjective:We describe a rare case of sudden onset of unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease, which is characterised by progressive stenosis of the intracranial internal carotid arteries and their proximal anterior cerebral arteries and middle cerebral arteries.Method:Case report and review of the world literature regarding moyamoya disease with hearing loss.Results:The reported patient had moyamoya disease that initially presented as sudden, unilateral sensorineural hearing loss. Magnetic resonance imaging showed occlusion of the anterior cerebral, middle cerebral and distal internal carotid arteries bilaterally. The possible mechanism of this patient's sudden sensorineural hearing loss may have been vascular occlusion resulting from thrombotic narrowing or blockage by plaque.Conclusion:The described patient represents the first reported case of sudden onset, unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease. The possibility of a vascular lesion such as moyamoya disease should be considered in patients with sudden sensorineural hearing loss, especially children, young adults and Asian patients. Due to this disease's poor outcome, early diagnosis and treatment are important to prevent stroke.

Intratympanic Steroids for Treatment of Sudden Hearing Loss after Failure of Intravenous Therapy

2007 ◽  
Vol 137 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Guillermo Plaza ◽  
Carlos Herráiz
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Standard Treatment ◽  
Sudden Hearing Loss ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Steroid Treatment ◽  
Sensorineural Hearing ◽  
Intravenous Steroid ◽  
Intratympanic Steroids

OBJECTIVE: We sought to describe our experience with intratympanic steroid treatment of sudden sensorineural hearing loss after failure of intravenous steroid treatment. STUDY DESIGN AND SETTING: We conducted a nonrandomized prospective clinical trial. Fifty patients presenting with sudden onset idiopathic hearing loss were treated intravenously over five days. After this period, patients with treatment failure (18 cases) were offered intratympanic steroid treatment. Nine patients refused, whereas the other nine patients received three weekly injections of methylprednisolone. Recovery of hearing was reported as improvement of more than 15 dB in pure tone average. RESULTS: Intratympanic steroid treatment improved hearing loss in five patients (55%). This is significant compared with those patients who refused intratympanic treatment, who showed no further improvement ( P < 0.05). No serious adverse effects were observed. CONCLUSION: Intratympanic steroids significantly improve the recovery outcome of sudden hearing loss that had not recovered after intravenous steroid treatment. SIGNIFICANCE: Intratympanic steroids are an effective and safe therapy in sudden sensorineural hearing loss cases that are refractory to standard treatment.

Bilateral sudden sensorineural hearing loss: review

2013 ◽  
Vol 128 (S1) ◽  
pp. S8-S15 ◽  
Author(s):  
S A Sara ◽  
B M Teh ◽  
P Friedland
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Age Of Onset ◽  
Age Distribution ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Medical Emergency ◽  
Mesh Terms ◽  
Pubmed Database ◽  
Bilateral Condition

AbstractIntroduction:Unilateral and bilateral sudden sensorineural hearing loss represent different disease entities. The unilateral condition is more common and predominantly idiopathic, and up to 65 per cent of patients spontaneously recover hearing. Conversely, the bilateral condition is rare, mostly associated with serious systemic conditions, and has a higher prevalence of morbidity and mortality.Methods:A literature search using the PubMed database was conducted using the MeSH terms ‘sudden’, ‘bilateral’ and ‘sensorineural hearing loss’.Results:One hundred and three reported cases of bilateral sudden sensorineural hearing loss were identified. The condition is most often associated with toxic, autoimmune, neoplastic and vascular conditions. A younger age of onset, with a bimodal age distribution, was seen for bilateral sudden sensorineural hearing loss, compared with the unilateral condition. Patients with the bilateral condition had more profound hearing loss, with poorer recovery and a 35 per cent mortality rate. Vestibular symptoms were also less common than in the unilateral condition.Conclusion:The presentation of bilateral sudden onset sensorineural hearing loss is a medical emergency requiring thorough and urgent investigation to exclude life-threatening and reversible conditions.

scholarly journals Sudden sensorineural hearing loss and bedside phone testing: a guide for primary care

2020 ◽  
Vol 70 (692) ◽  
pp. 144-145 ◽  
Author(s):  
Shilpa Ojha ◽  
Arthur Henderson ◽  
Warren Bennett ◽  
Matthew Clark
Keyword(s):  
Primary Care ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing

scholarly journals Biomarkers Suggesting Favorable Prognostic Outcomes in Sudden Sensorineural Hearing Loss

2020 ◽  
Vol 21 (19) ◽  
pp. 7248
Author(s):  
Jeon Gang Doo ◽  
Dokyoung Kim ◽  
Yong Kim ◽  
Myung Chul Yoo ◽  
Sung Su Kim ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Medical Emergency ◽  
High Density Lipoproteins ◽  
Platelet Glycoprotein ◽  
Cholesterol Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Cochrane Database

Sudden sensorineural hearing loss (SSNHL) is a medical emergency, making detailed examination to determine possible causes and early treatment important. However, etiological examinations in SSNHL do not always reveal a cause, and several factors have been found to affect treatment outcomes. Various studies are being performed to determine the prognosis and effects of treatment in patients who experience sudden hearing loss, and to identify biomarkers associated with this condition. Embase, PubMed, and the Cochrane database were searched using the key words SSNHL, prognostic, and biomarker. This search identified 4 articles in Embase, 28 articles in PubMed, and 36 in the Cochrane database. Of these 68 articles, 3 were duplicates and 37 were unrelated to the research topic. After excluding these articles, the remaining 28 articles were reviewed. Factors associated with SSNHL were divided into six categories: metabolic, hemostatic, inflammatory, immunologic, oxidative, and other factors. The associations between these factors with the occurrence of SSNHL and with patient prognosis were analyzed. Low monocyte counts, low neutrophil/lymphocyte ratio (NLR) and monocyte/high-density lipoproteins (HDL) cholesterol ratio (MHR), and low concentrations of fibrinogen, platelet glycoprotein (GP) IIIa, and TNF-α were found to be associated with good prognosis. However, these factors alone could not completely determine the onset of and recovery from SSNHL, suggesting the need for future basic and clinical studies.

scholarly journals Evaluation of idiopathic sudden sensorineural hearing loss

2015 ◽  
Vol 1 (1) ◽  
pp. 2
Author(s):  
Çiğdem Fırat Koca
Keyword(s):  
Hearing Loss ◽  
Early Diagnosis ◽  
Sensorineural Hearing Loss ◽  
Complete Recovery ◽  
Critical Issue ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Diagnosis And Treatment ◽  
Medical Emergency

<p class="abstract"><span lang="TR">Idiopathic sudden sensorineural hearing loss (ISSNHL) is a medical emergency. The early diagnosis and treatment should improve the complete recovery. The critical issue is diagnosis.</span></p>

scholarly journals Tuning Fork Testing in Sudden Sensorineural Hearing Loss

2013 ◽  
Vol 173 (8) ◽  
pp. 706 ◽  
Author(s):  
Andrew G. Shuman ◽  
Xue Li ◽  
Chris F. Halpin ◽  
Steven D. Rauch ◽  
Steven A. Telian
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Tuning Fork ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing
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