Sudden sensorineural hearing loss treatment

Akutna zamjedbena nagluhost je idiopatski, jednostrani gubitak sluha perceptivnog porijekla koji se razvija u manje od 72 sata. Većina pacijenata opisuje buđenje s oštećenim sluhom bez očitog vanjskog uzroka. Oštećenje sluha može biti jedva zamjetno do izrazito, a gluhoća je rijetki ishod. Neki pacijenti imaju i šum u zahvaćenom uhu. Postoje brojni mogući uzroci iznenadnog gubitka sluha (virusni, vaskularni ili autoimuni), ali često uzrok ostane nepoznat pa govorimo o idiopatskom zamjedbenom oštećenju sluha. Dijagnoza se postavlja kod pacijenata s navedenim simptomima i potvrđuje Weberovim testom koji lateralizira u zdravo uho. 35 do 60 % bolesnika se oporavi u potpunosti, uglavnom unutar 2 tjedna. Najbolja metoda liječenja za idiopatsko zamjedbeno oštećenje sluha još nije otkrivena zbog činjenice da mnogo pacijenata pokazuje spontani oporavak, bez obzira na liječenje. Većina otologa preporučuje propisivanje sistemskih kortikosteroida u pacijenata koji nemaju kontraindikacije. Glukokortikoidi su standardna terapija idiopatske zamjedbene nagluhosti. Međutim, s obzirom na to da su sistemski kortikosteroidi povezani s brojnim nuspojavama, rađene su studije njihove primjene intratimpaničnim putem, koje pokazuju nedosljedne rezultate. Postoji također potreba za kvalitetnijim istraživanjem hiperbarične oksigenoterapije u liječenju iznenadnog gubitka sluha. Vremenski okvir za učinkovitu terapiju je kratak, stoga je važno da svaki liječnik bude svjestan ovog stanja kako bi pacijenta uputio otorinolaringologu na vrijeme.Sudden sensorineural hearing loss refers to unexplained, unilateral hearing loss of sensorineural origin developing in less than 72 hours. Most patients describe waking up with hearing loss that has no apparent external cause. Hearing loss can range from barely detectable to profound, with deafness as an uncommon outcome. Some patients experience tinnitus in the affected ear. There are a lot of possible causes of sudden hearing loss (viral, vascular, or autoimmune causes), but often the cause remains unknown and is termed idiopathic sudden sensorineural hearing loss. The clinical diagnosis is made in patients presented with the symptoms mentioned and is confirmed by the Weber test, in which we can see lateralization to the healthy ear. Thirty-five to sixty percent of patients recover completely, most within 2 weeks. The best treatment for idiopathic sudden hearing loss has not been found yet due to the fact that a lot of patients show spontaneous improvement, regardless of treatment. Most otologists stay united in prescribing systemic corticosteroids to patients who have no contraindications. Glucocorticoids are the standard treatment for idiopathic sudden sensorineural hearing loss. However, as systemic steroids are associated with significant side effects, there were studies with intratympanic steroid therapy, which showed inconsistent results. There is also a need to fully investigate the effects of hyperbaric oxygenation for treatment of sudden hearing loss. The time frame for effective therapy is short, so it is important for every doctor to be aware of this condition and refer the patient to an otolaryngologist in time