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 that in adult sudden sensorineural hearing loss (SNHL)
- Sometimes associated with tinnitus/vertigo
In children it can be difficult to distinguish sensorineural hearing loss, which is an otological emergency, from a conductive loss due to common causes, eg otitis media effusion.
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
C.M. & G.T. 08-02-25
Who to refer:
If genuine SNHL is suspected, this requires early intervention with high dose Prednisolone (1mg/kg) for 7-14 days (Please see Primary Care Management for further detail).
Refer to ENT same day for formal assessment.
- 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 treatment:
- 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
Please discuss with the on-call ENT team.
