The first national treatment guideline for sudden hearing loss has been published (Otolaryngology-Head and Neck Surgery, March 2012). The condition sends thousands in the United States to the emergency room each year.
The guideline was developed by a 19-member panel led by Robert Stachler, MD, an otolaryngologist in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Hospital in Detroit.
"In most cases, patients will have multiple visits with several physicians and undergo extensive testing before a diagnosis is made," said Dr. Stachler. "There's also been a lack of one or more uniformly accepted treatments or a consensus on how to counsel patients who do not fully recover their hearing."
By focusing on opportunities for quality improvement, he said, "the guideline should improve diagnosis, reduce unnecessary tests and imaging procedures, and improve hearing for patients affected by sudden hearing loss."
The diverse panel of medical experts developed the guideline after reviewing the literature and reaching a consensus for patient diagnosis, management and follow-up care.
Sudden hearing loss is the rapid-onset of hearing impairment in one or both ears, generally occurring during a 72-hour period. Causes range from infection and trauma to inner-ear problems like Ménière's disease. Patients typically report having a feeling of a full or blocked ear. In many cases, evaluation and treatment often are delayed since the symptoms are common and non-specific.
The new guideline includes recommendations to help clinicians distinguish between conductive and sensorineural hearing loss, because they require very different treatment strategies; information to better educate patients about the benefits and risks of medical intervention; amplification and hearing assistive technology available to patients with incomplete recovery of hearing; and recommendations against clinicians ordering computerized tomography (CT) of the head and/or brain as part of the initial patient evaluation.
The guideline, intended for all clinicians who see adult patients, also covers sudden sensorineural hearing loss (SSNHL), a subset of sudden hearing loss. Approximately 4,000 new cases of SSNHL are reported in the United States each year. While most patients recover completely without medical intervention, about 15 percent experience hearing loss that worsens over time.
The complete guideline, published as a supplement to Otolaryngology-Head and Neck Surgery, is available online at http://www.entnet.org/.
Co-authors of the guideline are Kathleen Yaremchuk, MD, and Christopher Lewandowski, MD, of Henry Ford, and Sujana Chandrasekhar, MD, Sanford Archer, MD, Richard Rosenfeld, MD, MPH, Seth Schwartz, MD, MPH, David Barrs, MD, Steven Brown, MD, Terry Fife, MD, Peg Ford, Theodore Ganiats, MD, Deena Hollingsworth, RN, MSN, Joseph Montano, EdD, James Saunders, MD, Debara Tucci, MD, Michael Valente, PhD, Barbara Warren, PsyD, and Peter Robertson, MPA.