Sudden hearing loss should not be ignored
Patients presenting to general practice with sudden hearing loss, with or without tinnitus or vertigo, should be carefully assessed with audiometric testing and urgently referred if found to have true sensorineural hearing loss, clinicians have highlighted.
Sudden sensorineural hearing loss, which affects roughly 1 in 1000 of the general population every year, could be the only clinical sign of life-threatening conditions, such as a tumor or stroke, which may be treatable.
In a Seminar in The Lancet, Dr Benji Schreiber, from Royal Free Hampstead NHS Trust London, UK, and colleagues discussed the condition, its clinical presentation and treatment.
He told GP News: "I think the most important thing is that GPs don't just put sudden hearing loss down to viral labyrinthitis or a cold and they do arrange in every patient for there to be some formal audiometric testing. Patients with true sensorineural hearing loss should be referred on urgently."
Detailed investigation will show a specific cause for sudden sensorineural hearing loss in about 10% of patients. These include various infections, vascular and immune causes, as well as Ménière's disease and acoustic neuroma. Prompt treatment is therefore important.
For the remaining patients for whom no clear underlying cause is found, Dr Schreiber and colleagues recommend a short course of oral prednisolone started within 2 weeks of onset.
They say: "The prognosis in cases of isolated sudden sensorineural hearing loss is generally good, and improvement within a matter of days is common. Patients in whom there is no change within 2 weeks are unlikely to show much recovery."
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010