Update on Consensus on Diagnosis and Treatment of Idiopathic Sudden Sensorineural Hearing Loss
Acta Otorrinolaringologica Espanola
Herrera, M., Garcia Berrocal, J. R., et al. (2019).
Acta Otorrinolaringologica Espanola, 70(5), 290-300.
This is an updated guideline from the Scientific Committees of Otology, Otoneurology, and Audiology from the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL-CCC) providing recommendations on the diagnosis, treatment, and follow-up of idiopathic sudden sensorineural hearing loss.
Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC; Spain)
Patients with asymmetrical idiopathic sudden sensorineural hearing loss (ISSNHL; e.g., normal hearing or mild hearing loss in one ear and profound ISSNHL in the contralateral ear) should be considered for contralateral routing of signal (CROS) system, bone-anchored implant with CROS, or cochlear implantation.
For patients with bilateral, severe-to-profound idiopathic sudden sensorineural hearing loss who have not responded to other types of treatment and who do not receive benefit from hearing aids, cochlear implantation should be considered. Patients with asymmetrical hearing loss that is severe-to-profound in one ear and moderate-severe in the other ear should be considered for bimodal amplification (i.e., cochlear implantation in the ear with poorer hearing and hearing aid for the contralateral ear).
For patients with suspected idiopathic sensorineural hearing loss, audiological assessment should include case history, otoscopy, pure tone audiometry, speech audiometry, tympanogram, and a Rinne test using a tuning fork. For Spanish-speaking patients, pure tone audiometry should assess the following frequencies: 250 kHz, 500 kHz, 1,000 kHz, 2,000 kHz, 4,000 kHz, and 8,000 kHz. Speech audiometry should measure a patient's speech reception threshold and maximum discrimination according to the instructions of the Spanish Association of Audiology.
Patients with idiopathic sudden sensorineural hearing loss (ISSNHL) should be monitored on a schedule that includes:
<ul>
<li>pure tone audiometry at a 5-7 day check-up;</li>
<li>pure tone audiometry and speech audiometry at a 30 day check-up; and</li>
<li>pure tone audiometry, speech audiometry, and confirmation of ISSNHL diagnosis at a 12-month check-up.</li>
</ul>
For patients with suspected idiopathic sensorineural hearing loss, optional tests to be used as needed include auditory brainstem evoked response potentials, otoacoustic emissions, high-frequency audiometry, and vestibular assessments (i.e., vestibular evoked myogenic potential, or VEMP).
