Clinical Practice Guideline: Sudden Hearing Loss (Update)
Otolaryngology–Head and Neck Surgery
Chandrasekhar, S. S., Tsai Do, B. S., et al. (2019).
Otolaryngology–Head and Neck Surgery, 161(1 Suppl), S1-S45.
This guideline updates the 2012 Clinical Practice Guideline: Sudden Hearing Loss from the American Academy of Otolaryngology-Head and Neck Surgery Foundation. This updated document provides evidence-based recommendations for all clinicians who diagnose or manage adult patients who present with sudden hearing loss or sudden sensorineural hearing loss.
American Academy of Otolaryngology–Head and Neck Surgery Foundation
American Academy of Neurology; American College of Emergency Physicians ; American College of Radiology; American Neurotology Society; American Otological Society; American Speech-Language-Hearing Association; Society of Otorhinolaryngology and Head-Neck
"Clinicians should obtain follow-up audiometric evaluation for patients with [sudden sensorineural hearing loss] SSNHL at the conclusion of treatment and within 6 months of completion of treatment" (Recommendation, Grade C Evidence; p. 208).
When treating adults with sudden sensorineural hearing loss (SSNHL), clinicians should
<ul>
<li>"educate patients with SSNHL about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy" (Strong Recommendation, Grade B Evidence; p. 206), and</li>
<li>"counsel patients with SSNHL who have residual hearing loss and/or tinnitus about the possible benefits of audiological rehabilitation and other supportive measures" (Strong Recommendation, Grade B Evidence; p. 208).</li>
</ul>
When assessing adults with sudden sensorineural hearing loss (SSNHL), clinicians should
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<ul>
<li>“distinguish sensorineural hearing loss from conductive hearing loss when a patient first presents with SSNHL” (Strong Recommendation, Grade B and C Evidence; p. 202), </li>
<li>obtain a case history (Recommendation, Grade C Evidence), </li>
<li>conduct a physical examination for bilateral and recurrent episodes of SSNHL (Recommendation, Grade C Evidence), </li>
<li>“obtain audiometry as soon as possible (within 14 days of symptom onset)” (Recommendation, Grade C Evidence; p. 205), and </li>
<li>“evaluate patients with SSNHL for retrocochlear pathology by obtaining … auditory brainstem response (ABR)” (Recommendation, Grade C Evidence; p. 205).</li>
</ul>
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