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Sudden sensorineural hearing loss: when is it idiopathic?

Published online by Cambridge University Press:  17 March 2010

H Wilson  and
D J Alderson
H Wilson*
Affiliation:
Department of ENT Surgery, Royal Devon and Exeter Hospital (Wonford), Exeter, UK
D J Alderson
Affiliation:
Department of ENT, Torbay Hospital, Torquay, UK
*
Address for correspondence: Ms Helena Wilson, Department of ENT Surgery, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter EX2 5DW, UK. Fax: 01392 402820 E-mail: helenawilson@doctors.org.uk
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Abstract

Objective: To highlight the importance of assessing the certainty of a diagnosis of idiopathic sudden sensorineural hearing loss, and of modifying patient management accordingly.

Case report: A patient presented with sudden sensorineural hearing loss in the right ear. Following assessment and preliminary investigation, a diagnosis of idiopathic sudden sensorineural hearing loss was made. Steroid treatment was commenced. Two weeks later, the patient experienced sudden sensorineural hearing loss in the left ear, and scalp tenderness. Subsequent biopsy confirmed giant cell arteritis.

Conclusions: Management of idiopathic sudden sensorineural hearing loss should be guided by the level of certainty of diagnosis. If there is relative uncertainty, risk factors for specific diagnoses should be sought, the patient should be followed more closely, and investigation should be tailored appropriately. Giant cell arteritis should be considered in patients older than 50 years, those exhibiting suggestive signs or symptoms, and those with elevated inflammatory markers or deranged liver function tests.

Keywords

Hearing Loss, Sensorineural, IdiopathicTemporal ArteritisGiant Cell Arteritis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 6 , June 2010 , pp. 690 - 693
Copyright
Copyright © JLO (1984) Limited 2010

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