title: Current concepts in the management of idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  The purpose of this manuscript is to review the initial management strategies for idiopathic sudden sensorineural hearing loss, with an emphasis on the role that steroids play in treatment of this condition, and discuss options for auditory rehabilitation of persistent unilateral hearing loss.
  
  
  RESULTS
  Recent data suggest that hearing improvement may be greater for patients initially treated with both systemic and intratympanic steroid when compared with those treated with systemic steroids alone. Salvage intratympanic steroids have been shown to confer hearing benefit if initial management fails. The ideal dosing regimen for intratympanic steroids has not been established, but evidence supports that higher dosing strategies are advantageous. Cochlear implantation has emerged as a strategy for auditory rehabilitation of persistent unilateral hearing loss. Recent studies have demonstrated high patient satisfaction, subjective improvement in tinnitus, and objective performance benefit after cochlear implantation for single-sided deafness.
  
  
  CONCLUSIONS
  Patients can be offered steroid therapy in the initial management of idiopathic sudden sensorineural hearing loss, but should be counseled that the efficacy of steroids remains unclear. If patients fail to improve with initial management, salvage intratympanic steroid administration should be considered. If hearing loss persists long term, options for auditory rehabilitation should be discussed.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, The Otology Group, The Bill Wilkerson Center for Otolaryngology and Communication Sciences, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: O'Connell
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
mesh_terms: D000284:Administration, Oral; D003054:Cochlear Implants; D005938:Glucocorticoids / Q000627:therapeutic use; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000628:therapy*; D003639:Hearing Loss, Sudden / Q000628:therapy*; D006801:Humans; D000069555:Injection, Intratympanic; D016032:Randomized Controlled Trials as Topic
chemical_list: D005938:Glucocorticoids