AB085. 119. Presentation, treatment and outcomes of sudden sensorineural hearing loss

Background: The aim of this study is to evaluate the patterns of presentation of sudden sensorineural hearing loss in the unique environment of an Emergency Department specialising in Otolaryngology. Sudden sensorineural hearing loss (SSNHL) is an acute clinical entity that requires urgent specialist evaluation, treatment and follow up.

Methods: We performed a retrospective review of the presentation of patients attending our department from July 2016 to July 2017. Time to presentation, concomitant symptoms, family history, as well as treatment and outcomes were recorded.

Results: Forty-five patients presented with SSNHL Sudden Sensorineural hearing loss over a 12-month period. Eighteen patients self-presented, 25 were referred by their GP and 2 referred from audiology services. Mean time to presentation was 21 days; 46% of patients presented with 7 days of onset of symptoms. Eighty-two percent of patients were treated with steroids and acyclovir. Twenty-eight patients attended for follow up outpatient department (OPD). Repeat audiology showed an improvement in 12 patients (43%). MRI was performed for 55% of patients, and was normal in all cases. Of note, mean time to presentation among patients who had a resolution of symptoms was 11.8 days. Three patients had intratympanic steroid injection with one patient showing significant improvement.

Conclusions: SSNHL is a debilitating disorder with an acute onset. The mean time to presentation, of 21 days, suggests that patients are unaware of the significance of their symptoms. Early presentation and commencement of high dose steroids was associated with better outcomes in our cohort of patients. One patient showed a significant improvement in hearing with intratympanic steroids outside the treatment window which may suggest they have a role in refractory cases. We recommend the introduction of an educational programme for both general practitioners (GPs) and patients to increase awareness of this condition and appropriate management.

Keywords: Sensorineural; hearing loss; steroids; intratympanic injection