Treatment Options for Severe Sensorineural Hearing Loss
Diagnostic Confirmation
- Audiometric evaluation is essential to confirm the diagnosis of sensorineural hearing loss, distinguishing it from conductive hearing loss 3, 4
- Complete audiometric assessment should include air and bone conduction threshold measures, speech audiometry measures, and otoacoustic emission measures to determine cochlear function 5
Imaging and Further Workup
- MRI of the brain and internal auditory canals is recommended as the imaging study of choice to rule out retrocochlear pathology such as vestibular schwannoma 6, 4
- Auditory brainstem response testing may be considered as a less expensive alternative screening tool when MRI cannot be performed 7, 2
Treatment Options
- The American Academy of Otolaryngology-Head and Neck Surgery recommends hearing aids as first-line management for residual hearing 1, 2
- Cochlear implantation may be considered for severe to profound bilateral hearing loss when hearing aids provide insufficient benefit 1, 2
- For sudden sensorineural hearing loss, corticosteroids may be offered as initial therapy if within 2 weeks of symptom onset 7, 2
Counseling and Support
- Audiologic rehabilitation should be addressed as soon as the hearing loss is identified, and counseling should address the impact on communication, safety, function, cognition, and quality of life 7, 2, 9
Follow-up Care
- Follow-up audiometric evaluation should be obtained at the conclusion of any treatment and within 6 months of completion 8
- Regular monitoring of hearing status is recommended to assess for any changes and adjust management accordingly 2, 8