Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss (SSNHL) can have varying causes and etiologies and is considered a syndrome rather than a diagnosis. It is estimated that a cause is identified in only 10 % of patients diagnosed with the syndrome. Historically, there hav
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Sudden Sensorineural Hearing Loss Scott C. Montgomery, Carol A. Bauer, and Edward Lobarinas
Abstract Sudden sensorineural hearing loss (SSNHL) can have varying causes and etiologies and is considered a syndrome rather than a diagnosis. It is estimated that a cause is identified in only 10 % of patients diagnosed with the syndrome. Historically, there have been several proposed mechanisms for idiopathic SSNHL and today there are still questions and considerable debate regarding its etiology. Among the varied proposed mechanisms are immune-mediated disease, viral infection, vascular abnormalities, or a combination of multiple factors. This chapter reviews the current state of the science regarding idiopathic SSNHL, diagnosis, comorbidity, current therapeutic interventions, and emerging opportunities for disease management and treatment that are based on evidence-based practice. These include steroid treatment, hyperbaric oxygen therapy, drug therapy for viruses, intervention for vascular or ischemic etiology, salvage therapy, and posttherapy rehabilitation in cases of permanent hearing loss as well as the inherent challenges of providing intervention with varied evidence of efficacy.
Keywords Autoimmune inner ear disease Coagulopathy Herpes oxygen Intratympanic steroids Mumps Perilymphatic fistula Salvage Tinnitus Vertigo
Hyperbaric Serology
S.C. Montgomery (&) C.A. Bauer (&) Division of Otolaryngology, Southern Illinois University School of Medicine, 301 North Eighth St., Springfield, IL 62794, USA e-mail: [email protected] C.A. Bauer e-mail: [email protected] E. Lobarinas Callier Center for Communication Disorders, University of Texas at Dallas, 1966 Inwood Road, Dallas, TX 75256, USA e-mail: [email protected] © Springer International Publishing Switzerland 2016 C.G. Le Prell et al. (eds.), Translational Research in Audiology, Neurotology, and the Hearing Sciences, Springer Handbook of Auditory Research 58, DOI 10.1007/978-3-319-40848-4_4
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Introduction
Sudden sensorineural hearing loss (SSNHL) has many causes and etiologies and therefore is considered a syndrome rather than a diagnosis. It is estimated that a cause is identified in only 10 % of patients diagnosed with the syndrome (Schreiber et al. 2010). The lack of a common cause is particularly challenging for translational research efforts, both in narrowing down potential biogenerators for the disease process to guide basic research and for defining inclusion criteria for clinical trials. The most commonly accepted definition of SSNHL is based on symptoms rather than on a specific pathology. Diagnosis is generally based on the presence of sensorineural hearing loss greater than 30 dB at three consecutive frequencies in one or both ears on a standard audiogram occurring over 3 days or less (Stachler et al. 2012). In cases of unilateral loss, audiometric data are often not present before onset and the 30-dB differences are measured relative to the opposite ear. Idiopathic sudden sens
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