title: Variability in the management of idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  To evaluate current trends in the management of idiopathic sudden sensorineural hearing loss (ISSNHL), determine if variance in diagnostic and treatment protocols exists, and compare diagnostic and treatment strategies of ISSNHL between nonotologists/neurotologists (NONs) and otologists/neurotologists (ONs).
  
  
  METHODS
  Cross-sectional survey of practicing otolaryngologists.
  
  
  METHODS
  Otolaryngology practices within the United States.
  
  
  METHODS
  In January 2010, a survey was mailed to 500 NONs and 500 ONs. Data were collected and analyzed using χ(2), standard deviations, and variance.
  
  
  RESULTS
  A variety and distribution of responses were seen in the definition of ISSNHL, including dB loss necessary for diagnosis, number of consecutive frequencies involved, and maximum duration of hearing loss. Differences in diagnostic tools were also seen, with 50.4% of respondents (NON 34.2%, ON 66.7%; P = .0001) always using magnetic resonance imaging in their workup. Of the total respondents, 26.7% (NON 35.0%, ON 18.3%; P < .0001) preferred oral steroids alone; 22.1% (NON 11.7%, ON 32.5%; P < .0001) preferred a combination of oral and intratympanic steroids. Of the respondents, 68.6% (NON 57.5%, ON 80.0%; P = .0003) would continue with additional treatment after partial response; 20.8% (NON 33.3%, ON 8.3%; P < .005) would retreat with oral steroids alone and 46.6% (NON 35.8%, ON 57.3%; P < .05) with intratympanic injections. Overall, 69.2% (NON 45.8%, ON 92.5%; P = .0001) were very comfortable managing ISSNHL.
  
  
  CONCLUSIONS
  Significant differences exist in the diagnosis and treatment of ISSNHL. Such lack of uniformity highlights the need for strong evidence-based research-ultimately leading to formalized practice guidelines and educational outreach.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Virginia Commonwealth University, Richmond, Virginia 23298-0146, USA. dcoelho@mcvh-vcu.edu
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Coelho
authors.forename: Leroy R
authors.initials: LR
authors.lastname: Thacker
authors.forename: David W
authors.initials: DW
authors.lastname: Hsu
mesh_terms: D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009462:Neurology; D010036:Otolaryngology; D013256:Steroids / Q000008:administration & dosage; D014481:United States
chemical_list: D013256:Steroids