Management of Sudden-Onset Sensorineural Hearing Loss in Children

Abstract

Objectives:

(1) Report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). (2) Describe the etiology and management of children with SSNHL.

Methods:

Retrospective review of 20 children with SSNHL, from 2000-2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation.

Results:

The average age of patients presenting with SSNHL was 11 years 2 months (22 months-18 years). Only 6 (30%) presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptom, followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (30%), due to an anatomic abnormality (20%), endolymphatic hydrops (10%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, and both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing.

Conclusions:

The true incidence of SSNHL is unknown. Younger children may be unable to express hearing loss. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study, 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 20% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.