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Sudden sensorineural hearing loss

Author
Peter C Weber, MD, FACS
Section Editor
Daniel G Deschler, MD, FACS
Deputy Editor
Janet L Wilterdink, MD

INTRODUCTION

Sudden sensorineural hearing loss (SSNHL) involves an acute unexplained hearing loss, nearly always unilateral, that occurs over less than a 72-hour period. Most cases are idiopathic, and the prognosis depends on the severity of the hearing loss.

The diagnosis and treatment of SSNHL are discussed here. The evaluation of non-acute hearing loss and the differential diagnosis of hearing loss are discussed separately. (See "Evaluation of hearing loss in adults" and "Etiology of hearing loss in adults".)

EPIDEMIOLOGY AND RISK FACTORS

The exact incidence of sudden sensorineural hearing loss (SSNHL) is uncertain. Since recovery is often spontaneous, many affected people likely never seek medical attention. Estimates of incidence typically range from 2 to 20 per 100,000 people per year [1-3]. SSNHL can occur at any age, but most commonly affects patients 43 to 53 years of age [4].

Risk factors for idiopathic SSNHL are uncertain [5]. Similar numbers of men and women are affected [1]. Compared with patients with unilateral SSNHL, those with bilateral SSNHL are more likely to be older, have cardiovascular disease, and have a positive antinuclear antibody titer [1]. Some studies have suggested that diet (those low in fresh vegetables), low folate levels, and metabolic syndrome are associated with an increased risk of SSNHL [5-7]. There is also some evidence that patients with chronic otitis media may be at higher risk of developing SSNHL [8].

SSNHL may be a risk factor for stroke. In a study of patients in Taiwan hospitalized for treatment of a first episode of SSNHL, the risk of stroke over a five year follow-up period was increased compared to patients of similar age and demographics hospitalized for appendicitis (HR 1.64, 95% CI 1.31-2.07) [9]. However, in a review of the literature, the committee developing 2012 guidelines for the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) found that the relationship between SSNHL and risk of stroke did not meet their threshold for significance [3]. SSHNL has also been associated with an increased risk for myocardial infarction later in life [10].

                

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Literature review current through: Nov 2016. | This topic last updated: Mon Feb 29 00:00:00 GMT+00:00 2016.
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