Largest ever sudden hearing loss study highlights importance of urgent steroid treatment

The team of clinical scientists collaborated with 240 junior doctors across 76 hospitals in England and Wales between 2019 and 2022. The results show that patients who received steroids within seven days of their hearing loss starting were five times more likely to fully recover their hearing compared to those who were not given steroids. 

Importantly, they found that only 60 per cent of patients were actually treated within the first seven days as recommended. 

The root cause of acute or sudden sensorineural hearing loss lies in the inner ear, sensory organ or the vestibulocochlear nerve. Whatever its cause, there is potential for the auditory nerve to be permanently damaged, meaning the patient will suffer permanent hearing loss or tinnitus on the affected side without appropriate treatment. 

Management of acute sensorineural hearing loss is set out in the NICE Guidelines NG98: "If the hearing loss developed suddenly (over a period of 3 days or less) within the past 30 days. Refer immediately (to be seen within 24 hours) to an ear nose and throat service or emergency department".

Using the data provided as part of their study, the UCLH team has also created an online calculator that allows clinicians to work out the likelihood of a patient recovering their hearing completely with steroid treatment. 

Clinicians simply have to input the patient's age, whether they have cardiovascular disease, whether they have presented with vertigo, the time from onset to first treatment, and the severity of the patient's hearing loss.  A predicted probability is then provided.

This study is vital for the future management of patients suffering from sudden sensorineural hearing loss.  Not only does it allow clinicians to discuss steroid treatment and the likely success of this with patients (which allows them to make informed decisions on treatment options), it also reinforces what is known anecdotally by ENT surgeons that steroids are the best and first line treatment for acute sensorineural hearing loss.

I have many clients who have suffered a delayed diagnosis of acute sensorineural hearing loss owing to failures by their GPs or A&E staff to follow the NICE guidelines and refer them urgently to the local ENT department. 

They have been left with varying degrees of hearing loss, tinnitus, hyperacusis and vertigo which are all lifechanging.  The hope is that better education all medical professionals who encounter patients with acute sensorineural hearing loss will ensure that they receive the urgent steroid treatment that they need to stand the best chance of recovering their hearing. 

Read more about our delayed treatment claims and hear from Jamie's clients.