Sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL), is an important otological disorder that affects up to 5-20 in 100,000 people. It is characterized by a rapid loss of the hearing, usually unilateral, with a sensorineural hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours and can be associated with tinnitus and vertigo. It is a real sensorineural emergency that can become a permanent handicap if not adequately treated. Because of patients recovering rapidly or seeking no medical attention, the true figure might be higher, even if delaying SHL diagnosis and treatment may decrease the effectiveness of treatment. Sudden Hearing Loss can occur at any age but usually affects between 50 and 60 years old and the youngest patients affected are among 20-30 years old. There are not significantly differences in the prevalence between men and women[1-3]. Several pathophysiological mechanisms have been proposed to explain SHL (infective, vascular, and immune disease), but only 10 to 15 percent of the people have an identifiable cause; the majority of cases in fact remain 'idiopathic'[4].Because no specific cause is identified, the treatments are heterogeneous and can be considered empiric; on one hand therapies' aim is to correct the primary risk factors (smoke, diabetes, hypertension, previous viral or bacterial infections), on the other hand the purpose is to act on the main etiopathogenetic hypotheses (viral infection, immunologic, vascular compromise).