Outcomes of unilateral idiopathic sudden sensorineural hearing loss: Two decades of experience

OBJECTIVES: (a) Determine the demographic and medical risk factors for patients who presented with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL); (b) identify treatments that patients underwent; (c) evaluate the adequacy of follow‐up and compliance with long‐term hearing rehabilitation. METHODS: Retrospective review of patients who presented with unilateral ISSNHL between January 1998 and December 2017 at a tertiary care academic medical center. RESULTS: Two hundred‐four patients met inclusion criteria. Of these, 129 (63.2%) did not undergo treatment at an outside hospital prior to our evaluation. In this subgroup, the average pretreatment pure tone average (PTA) was 61.9 ± 2.5 dB (dB). The most common treatment was oral steroids and was recommended in 76 patients (59.9%). Patients also underwent intratympanic (IT) steroid injections (7.2%) or oral steroids followed by salvage IT injections (19.4%). Mean follow‐up duration was 17.9 (±29.2) months, and posttreatment PTA (45.6 ± 2.6 dB) was significantly better than baseline (P < .001). In this cohort, hearing amplification was infrequently recommended. Less than 20% of patients reported active hearing amplification use at their most recent visit. At follow‐up, 90 patients (69.8%) reported subjective improvement in hearing after treatment. Only 55 patients (42.6%) showed improvement in PTA compared to their pretreatment audiograms. CONCLUSION: Many patients with ISSNHL experienced audiometric improvement after treatments, but most had persistent hearing loss. The duration of follow‐up was short. Most patients did not use long‐term hearing amplification. Future studies are needed to identify factors that contribute to reduced follow‐up and low compliance with hearing amplification use in ISSNHL. LEVEL OF EVIDENCE: 2c.