Question

Sudden sensorineural hearing loss (SSNHL) is defined as ≥ 30 dB of SNHL over at least three contiguous frequencies developing within 3 days. What is the mainstay of treatment?

• A. Corticosteroids (systemic, with intratympanic steroids as salvage)
• B. Oral antiviral therapy alone
• C. Immediate cochlear implantation
• D. Broad-spectrum intravenous antibiotics

Hint:

Sudden SNHL is an emergency - reach for steroids, oral first then intratympanic.

Answer 1

The Correct Option is A

Step 1: Define the condition. Sudden sensorineural hearing loss (SSNHL) is an otologic emergency defined as a loss of ≥ 30 dB across at least three contiguous frequencies occurring within 72 hours (3 days). Most cases are idiopathic, with proposed viral, vascular and inflammatory mechanisms.

Step 2: Identify the first-line treatment. The mainstay is corticosteroids. Systemic (oral) steroids such as prednisolone are started as early as possible, since outcomes are best when therapy begins within the first 2 weeks.

Step 3: Salvage / adjunctive therapy. If there is incomplete recovery or contraindications to systemic steroids (e.g., diabetes), intratympanic steroid injection is used - either as primary therapy or as salvage after failed oral steroids. Hyperbaric oxygen may be considered as an adjunct in selected cases.

Step 4: Why the others are wrong. Routine antivirals and antibiotics have not shown benefit in idiopathic SSNHL. Cochlear implantation is reserved for permanent profound bilateral loss, not initial management.

Key fact: First-line treatment of SSNHL is corticosteroids (systemic first, intratympanic as salvage).