INTRODUCTION
Sudden onset sensorineural hearing loss (SSNHL) is defined as a 30 decibel(dB) loss in three consecutive frequencies occurring over less than 72 hours. It is most commonly idiopathic in nature, although there are numerous suggested aetiologies including immune, vascular and infective causes.1 Current guidelines suggest treating such patients with oral or intratympanic steroid therapies.
The American Academy of Otolaryngology Head and Neck Surgery, USA, published guidelines for the investigation, management and follow-up of patients presenting with SSNHL in Aug 2012.2Furthermore, they have recently published an update to this original guidance in 2019.3 ENT-UK have also recently published guidance on this area.4 It is suggested, through these guidelines and the literature, that patients should initially be treated with a course of oral steroids following SSNHL. This is typically 1mg/kg (Max 60mg) for 7 days, followed by a tapering dose for a further 7 days. The American Academy guidelines recommend that patients should be offered salvage intratympanic steroids (ITS) for patients who have incomplete recovery from SSNHL. ENT-UK guidance states that if there is no improvement from oral steroids after 7-14 days to consider salvage ITS therapy.
As a direct result of the American Academy guidelines, [removed for blind peer review] ENT department instigated salvage ITS therapy. This study follows the results of this treatment, in a real-world scenario within a busy teaching hospital, to provide a UK perspective on the benefits of this regime. We hope this will educate other departments as to how we instigated this service, and of the initial results obtained.