Sudden sensorineural hearing loss in adults: Our experience with multidrug high dose steroid regimen at tertiary care hospital

Introduction: Sudden sensorineural hearing loss is a confusing and controversial issue in our practice since no standard definition, evaluation method and treatment protocol exists. It is an otological emergency with narrow golden period of treatment. Objective: To establish the early diagnosis, treatment and study the outcome of treatment. Design and Method: In a prospective study, including patients >18 year age who had presented with sudden sensorineural hearing loss in ENT opd; after ENT examination, PTA, impedance audiometry and necessary imaging, were treated with i.v. methylprednisolone and inj.methylcobalamine i.m. along with tablet Pentoxyfylline and tablet prednisolone. PTA was repeated on 4 th day, 3 week, and 6 weeks after diagnosis. Results: Total 37 patients were diagnosed and treated. Majority of patients had sudden SNHL of < 72 hrs. duration with severe hearing loss and tinnitus as commonest associated symptom. Idiopathic cause was commonest followed by acoustic trauma and head trauma. 35.14% patients had complete recovery while 40.54% and 24.32% patients had partial and no recovery respectively. Conclusion: PTA is single most important investigation. Prompt treatment in < 72 hrs. carry good prognosis. Associated vertigo, flat audiogram, DM, HTN are of poor prognosis.