Pediatric Sudden Sensorineural Hearing Loss: Etiology, Diagnosis and Treatment in 20 Children

• Published in: International journal of pediatric otorhinolaryngology Vol. 88; pp. 208 - 212
• Main Authors: Dedhia, Kavita, MD, Chi, David H., MD
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2016
• Subjects: Adolescent; Audiometry, Pure-Tone; Child; Child, Preschool; Disease Management; Female; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - etiology; Hearing Loss, Sensorineural - therapy; Hearing Loss, Sudden - diagnosis; Hearing Loss, Sudden - etiology; Hearing Loss, Sudden - therapy; Humans; Infant; Injection, Intratympanic; Male; Meniere Disease - complications; Otolaryngology; Pediatric; Pediatrics; Retrospective Studies; Sensorineural hearing loss; Steroids - therapeutic use; Sudden hearing loss; Tinnitus - complications; Treatment Outcome; Vertigo - etiology; sensorineural hearing loss; sudden hearing loss; pediatric; Pediatric; Sensorineural hearing loss; Sudden hearing loss
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2016.07.003

Abstract Objectives 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To 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 is 11 years 3 months(22months-18years). Only 6(30%) children presented prior to 2 weeks. Tinnitus(55%) was the most common associated symptoms 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(25%), anatomic abnormality(25%), Meniere’s disease(5%), 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, both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing. Conclusions The true incidence of pediatric SSNHL is not well established in our literature. 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 40% 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.