60 Audit of Outpatient Management of Sudden Sensorineural Hearing Loss at St George’s Hospital

Introduction Sudden sensorineural hearing loss (SSNHL) is an acute otological problem and early treatment is thought to improve prognosis. ENT UK guidelines advise oral steroids as first-line treatment, followed by intra-tympanic steroids if there is no improvement. The aim of this audit was to assess outpatient management of SSNHL at St George’s Hospital. Method Data was collated from January – March 2023 of ENT emergency outpatient clinics for patients referred for SSNHL. Those without confirmation of SSNHL on pure tone audiometry (PTA) were excluded. Further analysis was made regarding treatment received and response. Results Our results showed that 36 patients were referred for SSNHL. 50% (18) were confirmed to be SSNHL on PTA. 83.3% (15) received a course of oral prednisolone with 20% (3) showing significant improvement in hearing. Of the 87% (13) who did not or had partial response to corticosteroid treatment, 38% (5) subsequently received IT steroid injections. 1 patient had an isolated IT steroid injection as they presented late. Of all those who received IT Injections (6), 67% (4) showed improvement in hearing. Conclusions Despite a poor response rate to oral prednisolone, 62% (8) were not subsequently treated with IT steroid injections. For 6 patients, the time delay from onset of symptoms was too great suggesting IT injection would be futile, 1 patient declined, 1 patient moved out of area. Further analysis into time delay from onset of SSNHL to ENT assessment would be beneficial. Consensus on maximum time limit to benefit from intratympanic steroid injection would also be of benefit.