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[Idiopathic sudden sensorineural hearing loss: a review]
1Service d'ORL et de chirurgie de la face et du cou, Assistance Publique-Hôpitaux de Paris, Université Paris VII Hôpital Lariboisière 2, rue Ambroise Paré 75010 Paris, France.
Summary
Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is an urgent condition with unknown causes. Current treatments are empirical, and evidence suggests rapid intervention is needed for effectiveness, though this is rarely feasible.
Area of Science:
- Otolaryngology
- Audiology
- Neuroscience
Context:
- Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is a critical otologic emergency with an unknown etiology.
- It presents as rapid, unilateral sensorineural hearing loss, diagnosed via audiogram.
- ISSHL encompasses heterogeneous conditions with diverse pathogenetic mechanisms.
Purpose:
- To review the current understanding of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) mechanisms and therapeutic approaches.
- To highlight the limitations of current diagnostic and treatment strategies for SSHL.
- To emphasize the need for novel diagnostic tools and evidence-based therapies for SSHL.
Summary:
- Audiograms classify SSHL into 5 types, aiding in identifying underlying mechanisms.
- Research explores infectious, ischemic, mechanical, and immunologic factors in cochlear dysfunction.
- Current treatments, like corticosteroids, are empirical and their cost-effectiveness is questionable.
Impact:
- The study underscores the lack of evidence supporting the 'therapeutic emergency' concept for SSHL.
- It suggests that effective treatment likely requires intervention within minutes of onset, a timeframe not practically achievable.
- There is a critical need for improved diagnostic tests to guide more effective and rational therapeutic strategies for SSHL.