This page was last reviewed 13-10-20
A rapid loss of hearing that occurs suddenly or over a period of up to 72 hours:
- Very rare in children
- Very little evidence, so management aligned to management of adults
- Sometimes associated with tinnitus/vertigo
Causes
- Idiopathic
- Viral (Mumps, CMV, EBV, Varicella Zoster)
- Other
- Autoimmune – Sarcoidosis, Wegener granulomatosis
- Trauma – Temporal bone fracture, acoustic trauma, head injury
- Drugs – Aminoglycoside antimicrobials, cisplatin
Problem:
In children it will be hard to establish a sensorineural loss rather than a conductive loss due to common causes, eg OME.
If genuine SNHL suspected, early intervention with high dose Prednisolone (1mg/kg) for 7-14 days. Refer to ENT urgently for formal assessment and audiology.
Primary Care Management
- Basic hearing assessment (talk to child, occlude one ear)
- Rule out conductive problems
- Otitis Media with Effusion
- Acute Otitis Media
- Otitis Externa
- Foreign Body
- Primary – Oral prednisolone* therapy, typically 1mg/kg (maximum of 60 mg) over 7-14 days and tapered over a similar period- ideally to be commenced within 72 hours of hearing loss
- Relative contraindications – insulin dependent diabetic, wide-angle glaucoma
- Can be discussed with on call ENT team
