{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:08:35Z","timestamp":1791821315378,"version":"4.3.4"},"reference-count":251,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T00:00:00Z","timestamp":1330560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence\u2010based recommendations for the diagnosis, management, and follow\u2010up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000\u00a0new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this guideline is to provide clinicians with evidence\u2010based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The panel made\n                      <jats:italic>strong recommendations<\/jats:italic>\n                      that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing\u2010assistive technology and other supportive measures. The panel made\n                      <jats:italic>recommendations<\/jats:italic>\n                      that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30\u2010dB hearing loss at 3 consecutive frequencies\n                      <jats:italic>and<\/jats:italic>\n                      an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow\u2010up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow\u2010up audiometric evaluation within 6\u00a0months of diagnosis for patients with ISSNHL. The panel offered as\n                      <jats:italic>options<\/jats:italic>\n                      that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3\u00a0months of diagnosis of ISSNHL. The panel made a\n                      <jats:italic>recommendation against<\/jats:italic>\n                      clinicians routinely prescribing antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants to patients with ISSNHL. The panel made\n                      <jats:italic>strong recommendations against<\/jats:italic>\n                      clinicians (1) ordering computerized tomography of the head\/brain in the initial evaluation of a patient with presumptive SSNHL and (2) obtaining routine laboratory tests in patients with ISSNHL.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599812436449","type":"journal-article","created":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T08:56:01Z","timestamp":1330592161000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":723,"title":["Clinical Practice Guideline"],"prefix":"10.1002","volume":"146","author":[{"given":"Robert J.","family":"Stachler","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Henry Ford Hospital Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujana S.","family":"Chandrasekhar","sequence":"additional","affiliation":[{"name":"New York Otology New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanford M.","family":"Archer","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head &amp; 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