title: Sudden sensorineural hearing loss in children: Etiology, management, and outcome.
abstract: OBJECTIVE
  Pediatric sudden sensorineural hearing loss (SSNHL) is uncommon, and the current guidelines for its management refer to adults. Our objective was to review cases of SSNHL in children and examine their etiologies, management, and outcome.
  
  
  METHODS
  We performed a retrospective chart review of all children under the age of 18 years treated for SSNHL between January 2003 and September 2014. Data recorded included age, gender, symptoms, onset of hearing loss, audiometric results, diagnostic studies, treatment, and outcome.
  
  
  RESULTS
  Nineteen children were included. Mean age was 14 years (range 7-18 years). Male: female ratio was 9:10. Degree of hearing loss varied from mild to profound across the tested frequencies. Most common accompanying symptom was tinnitus. Serologic tests demonstrated recent Epstein-Barr virus infection in one patient and previous cytomegalovirus infection in six patients. Imaging studies included computed tomography scan (n=3) and/or magnetic resonance imaging (n=12). All imaging studies did not demonstrate any pathology. Treatment included systemic steroids in 19 (100%) children and intratympanic steroids in eight (42%). Hearing completely improved in three (16%) children, partially improved in nine (47%), and there was no improvement in six (32%). One child was lost to follow-up.
  
  
  CONCLUSIONS
  Viral infection was a common finding in children with SSNHL and no pathological changes were demonstrated on imaging studies. In most patients (63%), hearing improvement was observed. Intratympanic steroid injection can benefit these children. Further studies are required to investigate the etiologies and establish guidelines for the management of SSNHL in children.
authors: Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Tel-Aviv, Israel. Electronic address: kobypi@hotmail.com.
authors: Jacob
authors: J
authors: Pitaro
authors: Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Tel-Aviv, Israel.
authors: Avital
authors: A
authors: Bechor-Fellner
authors: Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Tel-Aviv, Israel.
authors: Haim
authors: H
authors: Gavriel
authors: Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Tel-Aviv, Israel.
authors: Tal
authors: T
authors: Marom
authors: Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Tel-Aviv, Israel.
authors: Ephraim
authors: E
authors: Eviatar
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006309:Hearing; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D000069555:Injection, Intratympanic; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids
keywords: Child; Hearing loss; Injection; Intratympanic; Sensorineural; Steroids