Sudden sensorineural hearing loss: an evaluation of treatment and management approaches by referring physicians. Otolaryngol Head Neck Surg 2009 Jan;140(1):86-91
Date
01/10/2009Pubmed ID
19130968DOI
10.1016/j.otohns.2008.09.022Scopus ID
2-s2.0-58149092239 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
OBJECTIVE: To assess and compare the current management of sudden sensorineural hearing loss (SSHL) between primary care physicians and general otolaryngologists.
STUDY DESIGN: Written survey of physician practice patterns.
METHODS: A multiple choice and Likert scale survey was mailed to 1306 otolaryngologists and primary care physicians in the upper midwest with respect to management of SSHL.
RESULTS: A significant number of general practitioners treat SSHL independent of an otolaryngologist. General practitioners are significantly less impressed than otolaryngologists that steroids are an effective treatment (P < 0.0001). Over 98 percent of otolaryngologists use oral steroids as compared with 73 percent of general practitioners treating on their own. The vast majority of otolaryngologists start therapy with at least 60 mg of prednisone whereas lower doses and medrol dosepaks are more commonly used by general practitioners. Otolaryngologists are more likely to treat with steroids beyond one week of onset of hearing loss whereas general practitioners overwhelmingly will only treat within the first week. Approximately 50 percent of otolaryngologists add antiviral medications in contrast to 16 percent of generalists.
CONCLUSION: The approach to SSHL differs between otolaryngologists and general practitioners. The lack of strong evidence-based guidelines for the treatment of SSHL may underlie the variability in management by first line providers.
Author List
Shemirani NL, Schmidt M, Friedland DRAuthor
David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Administration, OralAntiviral Agents
Attitude of Health Personnel
Data Collection
Glucocorticoids
Hearing Loss, Sensorineural
Hearing Loss, Sudden
Humans
Methylprednisolone
Otolaryngology
Physicians, Family
Practice Patterns, Physicians'
Prednisone
Steroids
United States