From the Guidelines
Sensorineural hearing loss has several treatment options, including hearing aids, cochlear implants, corticosteroids, and auditory rehabilitation therapy, with the goal of improving hearing recovery and patient quality of life. The treatment approach depends on the severity and cause of the hearing loss. According to the clinical practice guideline update 1, prompt recognition and management of sudden sensorineural hearing loss may improve hearing recovery and patient quality of life.
Treatment Options
- Hearing aids are the most common treatment, amplifying sounds to make them more detectable by damaged hair cells.
- For profound hearing loss, cochlear implants may be recommended, which bypass damaged portions of the ear and directly stimulate the auditory nerve.
- Corticosteroids like prednisone (typically 60mg daily for 7-14 days) can sometimes help if the hearing loss is sudden or due to inflammation, especially when started within 2-4 weeks of onset, as suggested by the guideline update 1.
- For Ménière's disease-related hearing loss, diuretics like hydrochlorothiazide (25-50mg daily) may help manage symptoms.
- Certain medications like pentoxifylline or hyperbaric oxygen therapy are sometimes used for sudden hearing loss, though with variable results.
- Auditory rehabilitation therapy helps patients adapt to hearing loss and maximize their remaining hearing, as recommended by the guideline update 1.
Prevention and Rehabilitation
Prevention is also crucial - avoiding loud noise exposure and using hearing protection in noisy environments can prevent further damage. Unfortunately, most sensorineural hearing loss is permanent as damaged hair cells in the inner ear cannot regenerate, making early intervention essential for best outcomes. The guideline update 1 emphasizes the importance of distinguishing sensorineural hearing loss from conductive hearing loss and providing patients with information about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy. Additionally, the use of hearing-assistive technologies, such as hearing aids or auditory training devices, can be beneficial in improving communication and quality of life for patients with sensorineural hearing loss, as noted in the earlier guideline 1.
From the Research
Treatment Options for Sensorineural Hearing Loss
- Auditory rehabilitation, education, and eliminating or reducing use of ototoxic medications are key aspects of treatment 2
- Patients with sensorineural hearing loss should be referred to an audiologist for consideration of hearing aids 2
- Cochlear implants can be helpful for those with refractory or severe hearing loss 2, 3, 4
- Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only 3
- Unilateral cochlear implants provide improved hearing and significantly improve quality of life, and improvements in sound localization are noted for bilateral implantation 4
Rehabilitation and Management
- The care plan for patients with sensorineural hearing loss is usually more directed toward palliation than toward cure 5
- Therapy is directed more toward helping the patient cope with the loss of hearing rather than offering various medical or surgical interventions 5
- Managing the patient who is losing or who has lost hearing requires strategies that address the emotional and psychologic effects on the patient, the family, and those who surround patients in their daily lives 5