4
Key Points
Table 2. Summary of Key Action Statements (KAS)
Statement Action Grade
1. Exclusion of
CHL
Clinicians should distinguish SNHL from
CHL when a patient first presents with
sudden hearing loss.
Strong
recommendation
2. Modifying
factors
Clinicians should assess patients with
presumptive SSNHL through history and
physical examination for bilateral sudden
hearing loss, recurrent episodes of sudden
hearing loss, and/or focal neurologic
findings.
Recommendation
3. Computed
tomography
(CT)
Clinicians should NOT order routine CT
of the head in the initial evaluation of a
patient with presumptive SSNHL.
Strong
recommendation
against
4. Audiometric
confirmation of
SSNHL
In patients with sudden hearing loss
clinicians should obtain, or refer to a
clinician who can obtain, audiometry
as soon as possible (within 14 days of
symptom onset) to confirm the diagnosis
of SSNHL.
Recommendation
5. Laboratory
testing
Clinicians should NOT obtain routine
laboratory tests in patients with SSNHL.
Strong
recommendation
against
6. Retrocochlear
patholog y
Clinicians should evaluate patients with
SSNHL for retrocochlear patholog y by
obtaining an MRI or Auditory Brainstem
Response (ABR).
Recommendation
7. Patient education Clinicians should educate patients with
SSNHL about the natural history of
the condition, the benefits and risks of
medical interventions, and the limitations
of existing evidence regarding efficacy.
Strong
recommendation
8. Initial
corticosteroids
Clinicians may offer corticosteroids as
initial therapy to patients with SSNHL
within 2 weeks of symptom onset.
Option
9a. Initial therapy
with hyperbaric
oxygen therapy
(HBOT)
Clinicians may offer, or refer to a clinician
who can offer, HBOT combined with
steroid therapy within two weeks of onset
of SSNHL.
Option
9b. Salvage therapy
with HBOT
Clinicians may offer, or refer to a clinician
who can offer, HBOT combined with
steroid therapy as salvage within one
month of onset of SSNHL.
Option
