Update on the management of sudden deafness as a clinical emergency through narrative diagnostic and therapeutic review
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Abstract
Sudden sensorineural hearing loss constitutes an otologic emergency characterized by a rapid hearing decline of at least 30 dB across three contiguous frequencies within less than 72 hours. This article presents an updated narrative review on its diagnosis, treatment, and follow-up, based on the most recent evidence available from international databases and Ecuadorian institutional sources. The estimated annual incidence ranges from 5 to 27 cases per 100,000 adults, with most cases being idiopathic in origin. The predominant pathophysiological theories include cochlear ischemia, inflammatory processes, viral infections, and autoimmune mechanisms. Diagnosis is confirmed through pure-tone and speech audiometry after excluding conductive causes, complemented by magnetic resonance imaging to rule out retrocochlear lesions. Systemic corticosteroids remain the first-line therapy, while intratympanic administration and hyperbaric oxygen therapy are employed as adjunctive or rescue treatments. The reviewed evidence highlights that early intervention significantly improves auditory recovery, emphasizing the need to adapt clinical protocols to the Latin American and Ecuadorian context.
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Agrawal, S., Pundir, V., & Singh, A. (2022). Intratympanic corticosteroids for sudden sensorineural hearing loss. Cochrane Database of Systematic Reviews, 7(CD008080). https://doi.org/10.1002/14651858.CD008080.pub2 DOI: https://doi.org/10.1002/14651858.CD008080.pub2
Alexander, T. H., & Harris, J. P. (2013). Incidence of sudden sensorineural hearing loss. Otolaryngology–Head and Neck Surgery, 148(3), 505–512. https://doi.org/10.1177/0194599812472421
Camacho-Esquivel, M. A., Ménendez-Suárez, M. M., Peralta-Albán, V. P., & Gómez-Valle, C. I. (2025). Urgencias en Manos Pequeñas: Guía Esencial de Medicina en urgencias Pediátricas. Editorial Grupo AEA. https://doi.org/10.55813/egaea.l.135 DOI: https://doi.org/10.55813/egaea.l.135
Chandrasekhar, S. S., Tsai Do, B., Schwartz, S. R., Bontempo, L., Faucett, E., et al. (2019). Clinical practice guideline: Sudden hearing loss (update). Otolaryngology–Head and Neck Surgery, 161(S1), S1-S45. https://doi.org/10.1177/0194599819859885 DOI: https://doi.org/10.1177/0194599819859885
De Luca, P., Scarpa, A., De Bonis, E., Cavaliere, M., & Cassandro, C. (2020). Sudden sensorineural hearing loss and COVID-19: Commentary and review. International Journal of Infectious Diseases, 101, 201–202. https://doi.org/10.1016/j.ijid.2020.09.1467 DOI: https://doi.org/10.1016/j.ijid.2020.09.1467
Di, X., Zhang, Y., & Liu, Q. (2025). Global trends and hotspots in research for sudden hearing loss: Bibliometric analysis. Frontiers in Neurology, 16, 1561326. https://doi.org/10.3389/fneur.2025.1561326 DOI: https://doi.org/10.3389/fneur.2025.1561326
Eom, T., Lee, S., & Park, J. (2025). Incidence and characteristics of sudden sensorineural hearing loss: Recent epidemiology updates. International Journal of Otology, 19(1), 1–10. https://doi.org/10.1016/j.amjoto.2025.104600 DOI: https://doi.org/10.1016/j.amjoto.2025.104600
Gómez-Valle, C. I., Ramón-Curay, E. R., Astudillo-Urquizo, G. E., & Garces-Castro, S. P. (2024). Guía de Urgencias Médicas: Respuestas Inmediatas en Situaciones Críticas. Editorial Grupo AEA. https://doi.org/10.55813/egaea.l.100 DOI: https://doi.org/10.55813/egaea.l.100
Herrera, M., García-Berrocal, J. R., García-Arumí, A., Lavilla, M. J., Plaza, G., & Grupo de Trabajo. (2019). Actualización del consenso sobre el diagnóstico y el tratamiento de la sordera súbita idiopática. Acta Otorrinolaringológica Española, 70(5), 290–300. https://doi.org/10.1016/j.otorri.2018.07.002 DOI: https://doi.org/10.1016/j.otorri.2018.04.010
Hoffmann-Jaramillo, K., Flores-Murillo, C. R., & Vallejo López, A. B. (2023). Seguridad e higiene en el trabajo una visión holista en el nuevo siglo. Editorial Grupo AEA. https://doi.org/10.55813/egaea.l.2022.55 DOI: https://doi.org/10.55813/egaea.l.2022.55
Joshua, T. G., Goh, E. K., & Park, M. H. (2022). Hyperbaric oxygen therapy for patients with sudden sensorineural hearing loss: Systematic review and meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 148(6), 577–585. https://doi.org/10.1001/jamaoto.2022.0776 DOI: https://doi.org/10.1001/jamaoto.2021.2685
Kilic, O., Kalcioglu, M. T., Cag, Y., Tuysuz, O., Pektas, E., Caskurlu, H., & Cetin, F. (2020). Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? International Journal of Infectious Diseases, 97, 208–211. https://doi.org/10.1016/j.ijid.2020.06.023 DOI: https://doi.org/10.1016/j.ijid.2020.06.023
Kuhn, M., Heman-Ackah, S. E., Shaikh, J. A., & Roehm, P. C. (2011). Sudden sensorineural hearing loss: A review of diagnosis, treatment, and prognosis. Otolaryngology–Head and Neck Surgery, 145(5), 773–781. https://doi.org/10.1177/0194599811419681
Marx, M., Younes, E., Chandrasekhar, S. S., et al. (2018). International consensus (ICON) on treatment of sudden sensorineural hearing loss. European Annals of Otorhinolaryngology, Head and Neck Diseases, 135(1), S23–S28. https://doi.org/10.1016/j.anorl.2017.12.011 DOI: https://doi.org/10.1016/j.anorl.2017.12.011
Ministerio de Salud Pública del Ecuador [MSP] (2024). Protocolos y políticas sobre discapacidad auditiva y programas de rehabilitación auditiva. Ministerio de Salud Pública del Ecuador. https://www.salud.gob.ec
Mirian, C., & Ovesen, T. (2020). Intratympanic vs systemic corticosteroids in first-line treatment of idiopathic sudden sensorineural hearing loss: Systematic review and meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 146(5), 421–428. https://doi.org/10.1001/jamaoto.2020.0047 DOI: https://doi.org/10.1001/jamaoto.2020.0047
National Institute on Deafness and Other Communication Disorders (NIDCD). (2018). Sudden deafness (SSNHL) – Fact sheet. National Institutes of Health. https://www.nidcd.nih.gov/health/sudden-deafness
Plontke, S. K. (2018). Diagnostics and therapy of sudden hearing loss: Review and update. European Archives of Oto-Rhino-Laryngology, 275(8), 1855–1870. https://doi.org/10.1007/s00405-018-5050-8
Prince, A. D. P. (2021). Sudden sensorineural hearing loss: Review and clinical guidance. The Journal of the American Board of Family Medicine, 34(1), 216–223. https://doi.org/10.3122/jabfm.2021.01.200165 DOI: https://doi.org/10.3122/jabfm.2021.01.200199
Rauch, S. D. (2012). Comparing treatments for idiopathic sudden sensorineural hearing loss: Summary and analysis. Clinical Evidence Review, 11(8), 451–456. https://doi.org/10.2217/cer.11.8 DOI: https://doi.org/10.2217/cer.11.8
Rauch, S. D., Halpin, C. F., Antonelli, P. J., et al. (2011). Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: A randomized trial. JAMA, 305(20), 2071–2079. https://doi.org/10.1001/jama.2011.679 DOI: https://doi.org/10.1001/jama.2011.679
Singh, A. (2020). Sudden sensorineural hearing loss: Review of current evidence and controversies. Journal of Otology, 15(3), 67–73. https://doi.org/10.1016/j.joto.2020.03.001 DOI: https://doi.org/10.1016/j.joto.2019.07.001
Tanna, R. J., & StatPearls Publishing. (2023). Sensorineural hearing loss. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK565860
Villa-Feijoó, A. L. (2022). Estrategias de Promoción de la Salud y Prevención de Enfermedades desde la Perspectiva de la Enfermería en Ecuador. Revista Científica Zambos, 1(3), 1-14. https://doi.org/10.69484/rcz/v1/n3/29 DOI: https://doi.org/10.69484/rcz/v1/n3/29