Sudden Sensorineural Hearing loss

Treatment:

Most authorities noted that while numerous treatments have been studied aiming to improve blood flow, such as carbogen inhalation or stellate ganglion block, all remain controversial or simply lack convincing evidence of efficacy. there is presently a limited ability to determine what is the optimal treatment of SHL.

However, most studies suggest a better hearing prognosis for treated vs. untreated patients .

Antivirals seem reasonable, given the frequency that herpes family viruses have been associated with SHL.

Steroids : Studies have shown a 78% response to steroids and a 38% response to placebo in a double blind study. They found that the steroids had the greatest benefit in patients with moderate, unilateral sudden hearing loss less than 40 years of age.

The use of vasodilators is based on the premise that it promotes blood flow and eliminates vasospasm (i.e., the cause is vascular).

Immunosuppressants in sudden fluctuant SNHL: Wang et al recently reported that etanercept given acutely in experimental labyrinthitis resulted in much better hearing results. While this animal study may not apply to humans, it suggests that acute treatment with etanercept or a related anti-TNF drug (Remicade, Humira), may improve hearing results for sterile inflammation.

Keeping all these factors in mind a therapeutic protocol has been devised at the Clinic that allows us to give an improvement in over 80% of cases of sensorineural hearing loss presenting within 72 hours of onset of symptoms.

No guarantees can be given regarding the success of this therapeutic regimen due to the fact that there is no conclusive evidence regarding its etiology.

However 2 things are conclusively proved:

•  It is essential to provide early intervention.

•  treated patients have a better prognosis than untreated patients