Sudden Sensorineural Hearing Loss (SSHL): Why a Suddenly Silent Ear Is a Medical Emergency — A Complete Guide for Indian Patients

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Sudden sensorineural hearing loss (SSHL) is a rapid loss of hearing — typically 30 decibels or more within 72 hours, usually in one ear — and it is a true ENT emergency. Often described as “waking up deaf in one ear” or an “ear stroke”, it is treated most successfully when corticosteroids are started within the first 2 weeks, ideally within 72 hours. This guide explains causes (90% are idiopathic), red-flag symptoms, the tests an ENT specialist performs (audiometry, tuning-fork tests, MRI), gold-standard treatments including oral steroids, intratympanic steroid injections and hyperbaric oxygen — and what to do if hearing doesn’t fully recover. Expert evaluation is available at Harsiddh ENT Clinic, Bhuyangdev and Shaleen Clinic, Majestic Square, Sola, Ahmedabad.

Key Takeaways

• SSHL is a medical emergency — not “just a blocked ear”. Every hour counts. Steroid treatment works best when started within 72 hours and remains beneficial up to 2 weeks from onset.
• It is common and under-recognised. Sudden sensorineural hearing loss, known as SSHL, impacts more than 65,000 Americans each year — and thousands of Indians annually, most of whom dangerously assume it is earwax and wait.
• It usually strikes one ear. Typical signs: a sudden “pop” or muffling, a feeling of ear fullness, roaring tinnitus, and sometimes dizziness or vertigo.
• 90% of cases have no identifiable cause (called idiopathic SSNHL) — viral inner-ear inflammation, reduced blood supply and immune mechanisms are the leading theories.
• First, rule out simple causes. Wax, ear infection or fluid can mimic sudden deafness; a 5-minute otoscopy and tuning-fork test at an ENT clinic settles this instantly.
• Gold-standard treatments are oral corticosteroids and intratympanic (through-the-eardrum) steroid injections; hyperbaric oxygen therapy (HBOT) is a proven add-on, especially for severe loss.
• Even if hearing doesn’t fully return, you have options — modern hearing aids, CROS systems and cochlear implants restore communication and quality of life.

Introduction: The 2-Minute Read That Could Save Your Hearing

Imagine waking up and your left ear feels like it’s stuffed with cotton. You yawn, swallow, clean it with a bud — nothing changes. Phone calls sound distant on that side. By afternoon, a ringing starts. Most Indians do the same thing at this moment: nothing. “Wax hoga, saaf ho jaayega” — it’ll clear on its own.

That assumption is the single biggest reason hearing is permanently lost in this condition.

Here is why this topic is suddenly everywhere: the phrase “sudden sensorineural hearing loss, known as SSHL, impacts more than 65,000 Americans each year” has been trending across Facebook and health forums worldwide [1]. For India — a country of 140+ crore people with high rates of diabetes, viral infections and noise exposure — thousands of families face this emergency every single year, and most reach a specialist far too late.

The hard medical truth: the inner ear has a short rescue window. Steroid therapy started within 72 hours offers the best chance of recovery; beyond 2–4 weeks, the odds fall sharply [3][4]. Every day spent “waiting for the wax to clear” is a day of hearing slipping away.

In this comprehensive guide — written the way I explain it to my own patients in Ahmedabad — you will learn exactly what SSHL is, why it happens, the symptoms you must never ignore, how we diagnose it in minutes to hours, every evidence-based treatment (with honest pros and cons), how to protect your remaining hearing, and precisely when to rush to an ENT specialist.

Related: Hearing Tests & Pure Tone Audiometry in Ahmedabad

What Is Sudden Sensorineural Hearing Loss (SSHL)?

Sudden sensorineural hearing loss (abbreviated SSHL or SSNHL) is defined by international guidelines as a hearing drop of at least 30 decibels (dB) across at least 3 connected frequencies, occurring within 72 hours [3][4]. In plain language: hearing that was fine — or felt fine — becomes significantly muffled over hours or, at most, three days.

To understand it, picture the hearing pathway:

• Outer ear — the ear canal, ending at the eardrum
• Middle ear — the eardrum and three tiny bones that amplify sound
• Inner ear — the snail-shaped cochlea, lined with thousands of microscopic hair cells that turn vibration into electrical signals
• Auditory nerve — carries those signals to the brain

A “sensorineural” loss means the problem lies in the cochlea (hair cells), the auditory nerve, or both — unlike conductive loss (wax, infection, a perforated drum), where sound simply can’t travel through. This distinction is precisely why the very first step of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) guideline is to separate sensorineural from conductive hearing loss at first presentation [2][3].

Key Facts at a Glance

• How common? Reported incidence is 5–27 per 100,000 people per year — over 66,000 new cases annually in the United States alone [1]. Indian incidence data is limited, but scaling by population, thousands (likely lakhs) of Indians experience SSHL every year; under-reporting is rampant because mild cases resolve unnoticed or are dismissed as “ear blockage”.
• Which ear? Overwhelmingly one-sided (unilateral) — bilateral simultaneous loss occurs in barely 1–2% of patients and signals a more serious underlying cause [4][6].
• Who gets it? Any age, but peak incidence is between 40 and 60 years; it is slightly more common in men and in those with diabetes [1][5].
• What usually causes it? In more than 90% of patients, no cause is ever proven — this is termed idiopathic sudden sensorineural hearing loss (ISSHL) [4]. The leading theories are viral inflammation of the cochlea, disruption of its delicate blood supply (sometimes called an “ear stroke”), immune-mediated attack, and rupture of inner-ear membranes [5][6].
• Can it recover on its own? Roughly one-third to two-thirds of patients recover some hearing spontaneously — but that statistic is precisely what makes people complacent. Recovery is unpredictable, often partial, and treatment meaningfully shifts the odds in your favour [4][6][7].

Think of the cochlea as a tiny sponge that needs constant blood flow. Its hair cells have almost no ability to regenerate. Whether the trigger is a virus or a micro-clot, the dying window of those hair cells is measured in days, not weeks — which is why ENT specialists worldwide treat SSHL with the same urgency that cardiologists treat chest pain.

Related: Understanding Your Inner Ear — Causes of Hearing Loss Explained

Causes and Risk Factors of Sudden Sensorineural Hearing Loss

Since 90% of cases are idiopathic, doctors speak in terms of leading theories and identifiable causes [5][6]. An ENT’s job is twofold: start emergency treatment immediately, and simultaneously hunt for the 10% of causes that need specific treatment.

The Leading Theories (Idiopathic SSHL)

1. Viral cochleitis (inner-ear viral inflammation). The most widely accepted theory. Many patients report a cold, flu or viral fever in the days before their hearing dropped. Viruses such as herpes family viruses, mumps and influenza can inflame the cochlea and auditory nerve [5][6].
2. Vascular disruption (“ear stroke”). The cochlea is fed by a single, hair-thin end-artery. A micro-clot, spasm or bleed here starves the hair cells of oxygen within minutes — analogous to a brain stroke, hence the nickname. This explains why SSHL clusters with the same risk factors as heart disease: diabetes, hypertension, high cholesterol and smoking [1][12].
3. Immune-mediated inner-ear disease. The immune system can mistakenly attack inner-ear proteins. Autoimmune conditions (such as Cogan’s syndrome, lupus) classically cause rapidly progressive, sometimes bilateral and recurrent loss [4][6].
4. Inner-ear membrane rupture. Sudden pressure events — violent sneezing, straining, weightlifting, diving, flights — can tear the round or oval window membranes (a perilymph fistula), leaking inner-ear fluid and dropping hearing instantly.

Identifiable Causes Your ENT Must Exclude

• Earwax or middle-ear fluid/infection — conductive lookalikes, effortlessly treated (this is why the “wait, it’s just wax” gamble is unnecessary: one look with an otoscope answers it)
• Vestibular schwannoma (acoustic neuroma) — a benign tumour on the hearing nerve; roughly 1–10% of SSNHL presentations hide one, which is exactly why an MRI is mandatory in most protocols [2][6]
• Ototoxic medications — certain IV antibiotics (aminoglycosides), high-dose aspirin, loop diuretics, some chemotherapy drugs
• Head or acoustic trauma — temporal bone fracture, blast exposure, sudden extreme noise
• Ménière’s disease — fluctuating loss with vertigo and fullness (its first episode can mimic SSHL)
• Neurological causes — multiple sclerosis, or rarely a small brainstem stroke
• Infections — Lyme disease, syphilis, HIV and others in specific risk settings
• Barotrauma — scuba diving, forceful nose-blowing during a cold, air travel with blocked ears

Who Is at Higher Risk?

• Adults 40–60 years old [1]
• People with diabetes, hypertension, dyslipidaemia — cardiometabolic disease damages cochlear microcirculation [12]
• Smokers and those with high stress or poor sleep
• Anyone with a recent viral illness
• People with autoimmune disease or fluctuating ear symptoms
• Divers, frequent flyers with colds, and heavy lifters (pressure-related fistula risk)

Signs and Symptoms of Sudden Sensorineural Hearing Loss: Mild vs Severe

SSHL rarely causes pain — which is exactly why it is underestimated. Knowing the signature pattern helps you act in hours, not weeks.

The Classic Presentation

• Sudden muffling or deadness in one ear — many patients notice it on waking, or within seconds as a “pop” followed by muffled hearing, as if the volume knob was turned down
• Tinnitus — roaring, hissing or ringing in the affected ear, present in up to 80–90% of cases; sometimes the tinnitus is noticed before the hearing drop itself [5][6]
• Aural fullness — a persistent blocked/pressure feeling that yawning and swallowing don’t relieve
• Muffled speech quality — voices sound distant or “underwater” on that side; many patients first notice while on a phone call
• Dizziness or vertigo in 30–40% of patients — spinning, unsteadiness, sometimes nausea [5][6]
• Difficulty localising sounds — you can’t tell where a voice or horn is coming from

A Quick Home Check (While You Arrange an ENT Visit — Not Instead of One)

• Rub your thumb and finger together beside each ear separately — is one side dramatically duller?
• Hold your phone to each ear alternately — same caller volume both sides?
• Hum aloud: does the hum sound louder inside the blocked-feeling ear? (A tuning-fork-style clue ENTs formalise with the Weber test)

Mild vs Severe: How We Grade the Emergency

Important: “mild” SSHL is still an emergency. Moderate losses have the best treatment response — which is only available if you come early [2][4].

How ENT Specialists Diagnose Sudden Sensorineural Hearing Loss

Diagnosis is fast, painless and — in a well-equipped ENT clinic — largely completed in a single visit. At Harsiddh ENT Clinic, Bhuyangdev, and Shaleen Clinic, Majestic Square, Sola, the pathway follows the international AAO-HNS guideline sequence [2][3]:

Step 1 — Focused History (Minutes)

Exact onset time and circumstances, one or both ears, tinnitus, vertigo, recent viral illness, loud-noise or pressure events, current medicines, and cardiac risk factors. History also screens for the guideline’s red-flag features — bilateral loss, recurrent episodes, or neurological symptoms — which change the workup [2].

Step 2 — Otoscopy with 4K UHD Visualisation

A quick look inside the ear canal under high-definition 4K UHD endoscopy rules out the great imposters in seconds: wax plugs, fungal debris, infection, drum perforation, or middle-ear fluid. Patients see their own eardrum on screen — and the answer to “is it just wax?” is settled immediately.

Step 3 — Tuning-Fork Bedside Tests

• Rinne test: compares air vs bone conduction
• Weber test: a 512 Hz fork on the forehead — in sensorineural loss, the sound lateralises to the better ear; in conductive loss, to the blocked ear

These 30-second tests are the guideline-mandated way to separate sensorineural from conductive loss at presentation [2][3].

Step 4 — Audiological Confirmation

• Pure-tone audiometry (PTA): the gold standard — confirms the ≥30 dB/3-frequency/72-hour definition, grades severity, and maps which frequencies are lost. Guidelines advise audiometry as soon as possible, within 14 days of onset [2]
• Speech audiometry and tympanometry: assess real-world word understanding and middle-ear pressure/function
• Otoacoustic emissions (OAEs) & ABR where indicated

Step 5 — Imaging and Targeted Tests

• MRI of the inner ear/internal auditory canal (with contrast) — recommended for essentially all SSNHL patients to exclude vestibular schwannoma and other retrocochlear pathology; ABR is an accepted alternative where MRI isn’t possible [2]
• No routine CT head and no blanket “shotgun” blood panels — the guideline specifically recommends against these; blood tests are targeted to your history (e.g., sugar, lipids, autoimmune/infectious markers) [2]

Treatment Options for Sudden Sensorineural Hearing Loss: Medical, Procedural & Supportive

Here is the guiding principle of modern SSHL care: time lost is hearing lost. Treatment is started empirically — before all reports return — because delay costs more than any test can answer [2][4][6].

1. Oral Corticosteroids — The First-Line Backbone

A short, tapered course of high-dose oral steroids (typically prednisolone ~1 mg/kg, maximum around 60 mg daily, tapered over 10–14 days) remains the globally accepted first-line treatment, ideally begun within 72 hours and up to 2 weeks from onset [2][4]. Steroids reduce inner-ear inflammation and oedema regardless of whether the trigger was viral or vascular. The evidence is honest: Cochrane reviews note the trial-quality is modest, yet steroids persist as standard care because the risk–benefit balance in a rescue-window emergency strongly favours treatment [7]. Diabetic or steroid-sensitive patients are monitored closely or steered toward the intratympanic route below.

2. Intratympanic Steroid Injections — Direct Delivery to the Inner Ear

Intratympanic (IT) steroid therapy places concentrated steroid directly through the eardrum into the middle ear, where it diffuses into the cochlea. Performed as a clinic procedure under endoscopic/microscopic visualisation with surface anaesthesia, it takes minutes and avoids systemic steroid side effects — making it ideal for diabetics, hypertensives and the elderly [8][9]. A landmark JAMA randomised trial by Rauch et al. found IT dexamethasone to be non-inferior to oral steroids as initial therapy, and guidelines recommend IT steroids as salvage therapy within 2–6 weeks for patients not recovering adequately [2][8]. Many centres (ours included) frequently use combined oral + intratympanic therapy for severe losses.

3. Hyperbaric Oxygen Therapy (HBOT) — The Evidence-Backed Add-On

HBOT (breathing pure oxygen in a pressurised chamber) floods the oxygen-starved cochlea. Two major JAMA Otolaryngology meta-analyses — Rhee et al. (2,401 patients, 2018) and Joshua et al. (randomised trials, 2022) — found that adding HBOT to medical therapy significantly improves hearing recovery and absolute hearing gain, with the greatest benefit in severe-to-profound loss and when started early [10][11]. Guidelines now list HBOT (with steroids) as an option within 2 weeks of onset, or within about 1 month as salvage [2].

4. What International Guidelines Say NOT to Do

The AAO-HNS guideline explicitly recommends against routine use of antiviral drugs, vasodilators, thrombolytics and vasoactive “cocktails” — decades of trials show no benefit over steroids, with added cost and risk [2][3][6]. Beware of “miracle drip” packages marketed aggressively; they divert time and money from treatments that actually work.

5. If Hearing Doesn’t Fully Recover — You Still Have Powerful Options

Recovery is judged over 3–6 months with follow-up audiometry (a guideline requirement) [2]. For residual loss:

• Digital hearing aids — today’s devices are discreet, rechargeable, Bluetooth-enabled and dramatically improve speech clarity
• CROS/BiCROS systems for single-sided deafness — wirelessly route sound from the deaf side to the hearing ear
• Bone-conduction implants (BAHA-type) for selected candidates
• Cochlear implants — now an established, life-changing option for severe-to-profound non-recovering loss, including single-sided deafness; evaluation and surgery are facilitated at Shaleen Clinic, Majestic Square, Sola, with cashless insurance assistance

Our centre’s wider surgical ecosystem — 4K UHD endoscopy-guided ear surgery, laser-assisted stapedotomy for conductive hearing loss such as otosclerosis, and coblation technology for adenoid/tonsillar disease contributing to ear problems (e.g., recurrent middle-ear fluid) — means every type of hearing impairment, not just SSHL, is managed under one roof. Related: Cochlear Implant Evaluation & Hearing Rehabilitation

6. Home Care & Supportive Measures (Adjuncts — Never Substitutes)

• Absolute treatment urgency first: no home remedy, oil, or ear drops can rescue dying hair cells — use the golden window
• Rest, hydration, good sleep; avoid straining, heavy lifting and forceful nose-blowing during recovery (protects healing inner-ear membranes)
• Strict noise protection — no loud music, celebrations-firecrackers, or power tools against recovering ears
• Tinnitus support: low-level background sound at night, reduced caffeine/salt, and guided counselling — most tinnitus softens as hearing recovers [2]
• Control diabetes/BP meticulously — vascular health protects the other ear [12]

Treatment Options at a Glance — Honest Pros & Cons

The Recovery Timeline — What Improvement Actually Looks Like

Patients often panic when hearing is not normal in three days. Recovery is a curve, not a switch. Here is the realistic trajectory we counsel at our clinics [2][4][6]:

Myth vs Fact:

• ❌ Myth: “If it were serious I would have ear pain.” ✅ Fact: SSHL is usually painless — absence of pain is exactly what makes people delay.
• ❌ Myth: “Putting warm oil or garlic juice will open the ear.” ✅ Fact: No topical drop can reach the cochlea — and it wastes the golden window.
• ❌ Myth: “It happened because I cleaned my ears too hard.” ✅ Fact: Cleaning cannot damage the inner ear — the cause lies far deeper than any bud reaches

Prevention: Can Sudden Sensorineural Hearing Loss Be Prevented?

Idiopathic SSHL can’t be guaranteed-against — but you can meaningfully lower risk and, crucially, protect yourself from permanent loss by responding correctly:

1. Manage your vascular health like your hearing depends on it — because it does. Diabetes, hypertension and cholesterol are proven associates of sudden hearing loss; keep sugar, BP and lipids in target range [1][12].
2. Quit smoking. Smoking constricts the cochlea’s already fragile microcirculation.
3. Treat colds and ear/nose/throat infections promptly, and avoid flying, diving or forceful nose-blowing while congested — pressure events on an inflamed system are a known trigger.
4. Respect ototoxic drugs. Never self-medicate with high-dose aspirin long-term; if prescribed aminoglycosides or chemotherapy, ask about baseline and follow-up audiometry.
5. Protect your ears from noise. Firecrackers, weddings, gyms with blaring speakers, industrial noise — use earplugs; acoustic trauma is a recognised precipitant.
6. Never insert cotton buds, pins or oil into the ear canal — and never let “it must be wax” delay an emergency evaluation [2].
7. Stay vaccinated (measles–mumps–rubella, influenza) — viral illnesses are the leading suspected trigger of SSHL [5][6].
8. Sleep, stress, immunity. Chronic sleep deprivation and extreme stress are emerging risk modifiers for microvascular inner-ear events.
9. Know your baseline. If you’re over 50, diabetic, or work in noise, a yearly screening audiogram is inexpensive insurance — a baseline makes any change instantly visible.
10. Memorise the emergency rule: any ear that suddenly goes dull, especially with ringing or fullness, deserves an ENT evaluation the same day — not next week.

When to See an ENT Specialist Immediately 🚩

Go the same day — to an ENT clinic or emergency — if you notice:

• Hearing that dropped suddenly in one (or both) ears — overnight, in hours, or after a “pop”
• Sudden hearing loss with spinning vertigo or nausea
• Hearing loss with new loud tinnitus or persistent ear fullness
• Any sudden hearing change after a loud blast, dive, flight, or heavy straining

Go to emergency services immediately if sudden hearing loss comes with facial weakness, severe headache, slurred speech, double vision, loss of balance you can’t walk with, or confusion — these suggest a neurological event, not an ear one [2].

And the critical rule even for “small” symptoms: do not wait more than 24–48 hours assuming it is wax. A two-minute examination answers that question definitively — and if it isn’t wax, you are already inside the golden treatment window [2][4].

Same-week urgent review is warranted for: persistent one-sided tinnitus without hearing loss, or fluctuating hearing in one ear — both occasionally precede or accompany SSHL and merit audiometry.

📍 For rapid evaluation in Ahmedabad: Harsiddh ENT Clinic, Bhuyangdev (walk-in emergency assessment, same-visit 4K otoendoscopy & audiometry coordination) and Shaleen Clinic, Majestic Square, Sola (advanced diagnostics, steroid protocols, MRI coordination, and cashless admission facilities where needed).

Frequently Asked Questions (FAQ)

Is sudden sensorineural hearing loss a medical emergency?

Yes. SSHL is an ENT emergency because treatment — chiefly corticosteroids — is most effective within 72 hours and beneficial up to two weeks. Delaying to “see if it clears” permanently reduces recovery odds. Any sudden one-sided hearing drop warrants same-day specialist evaluation [2][4].

What causes sudden sensorineural hearing loss in one ear?

In over 90% of patients no cause is proven (idiopathic). Leading theories include viral inner-ear inflammation, disrupted blood supply to the cochlea (“ear stroke”), immune attack, and inner-ear membrane leaks. Rarer identifiable causes include nerve tumours, ototoxic drugs and autoimmune disease [5][6].

Can sudden hearing loss recover on its own without treatment?

Yes — roughly one-third to two-thirds of patients recover some hearing spontaneously. However, recovery is unpredictable and often incomplete. Early steroid therapy measurably improves outcomes, so guidelines advise offering treatment promptly rather than waiting for natural recovery [2][4][6].

What is the fastest, most effective treatment for SSHL?

High-dose oral corticosteroids started within 72 hours are first-line. Intratympanic steroid injections — non-inferior in a JAMA randomised trial — are used initially or as rescue within 2–6 weeks. Hyperbaric oxygen adds proven benefit, especially in severe loss [2][8][10].

Is the intratympanic steroid injection painful?

No. The eardrum is numbed with topical anaesthetic gel, and the injection takes seconds under endoscopic guidance. Patients feel brief fullness or momentary giddiness, rest lying down 20–30 minutes afterwards, and go home the same day. It avoids oral steroids’ systemic side effects [8][9].

Why did my ENT order an MRI for sudden hearing loss?

Guidelines recommend MRI (or ABR testing) for SSNHL patients to exclude vestibular schwannoma — a benign nerve tumour found in a small but important percentage of cases — and other retrocochlear causes. It is a precaution, not an indication something is seriously wrong [2].

Will my hearing fully return after SSHL? What is the prognosis?

Prognosis depends on severity, age, vertigo presence and — critically — treatment timing. Mild-to-moderate loss treated early often recovers well; profound loss with vertigo recovers less reliably. Improvement continues over 3–6 months, which is why follow-up audiometry is essential [2][4][7].

Can sudden hearing loss be a sign of a stroke or brain tumour?

Rarely, yes — either a small brainstem stroke or vestibular schwannoma can present as sudden deafness. Warning signs include loss in both ears, severe dizziness, facial weakness or other neurological symptoms. This is why examination and MRI screening are standard practice [2][6].

What if steroids don’t work — what are my options after failed SSHL treatment?

If hearing remains impaired after 3–6 months, options include digital hearing aids, CROS/BiCROS systems for single-sided deafness, bone-conduction implants, and cochlear implants for profound loss. Tinnitus counselling and auditory rehabilitation complete recovery of communication and confidence [2].

Is SSHL treatment covered by insurance or cashless facilities in Ahmedabad?

Yes — evaluation, steroid therapy, intratympanic injections and any required admission or implant surgery are generally covered under standard health-insurance policies. At Shaleen Clinic, Majestic Square, Sola, our team assists with cashless pre-authorisation, documentation and claim processing across major insurers and TPAs.

Conclusion: Your Hearing Has a Deadline — Respect It

Sudden sensorineural hearing loss is one of the very few true emergencies in ENT — a condition where the calendar is as important as the prescription. The message is simple enough to remember in one line: a suddenly muffled ear is never “just wax” until a specialist has looked, tested, and told you so.

The science is reassuring when acted upon quickly: oral and intratympanic corticosteroids, combination protocols, and hyperbaric oxygen give most early-presenting patients a genuine fighting chance, and modern rehabilitation — hearing aids to cochlear implants — ensures that even stubborn cases are never the end of communication, career or confidence [2][8][10][11].

If you or a family member has experienced a sudden drop in hearing, ringing, or blockage do not wait and do not self-treat. Walk in for a same-day evaluation at Harsiddh ENT Clinic, Bhuyangdev or Shaleen Clinic, Majestic Square, Sola, Ahmedabad — where 4K UHD ear endoscopy, rapid audiometry coordination, guideline-based steroid protocols and advanced hearing rehabilitation are available under one roof, with cashless facility assistance.

Share this article — the next case of “suddenly blocked ear” in your family or friend circle could be rescued by someone simply knowing it is an emergency.

This article is educational and does not replace an individual consultation. Treatment decisions are personalised between you and your treating ENT specialist.

References

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3. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical Practice Guideline: Sudden Hearing Loss. Otolaryngol Head Neck Surg. 2012;146(3_suppl):S1-S35. PMID: 22383545. https://doi.org/10.1177/0194599812436449
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7. Wei BP, Mubiru S, O’Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev. 2013;(7):CD003998. PMID: 23818120. https://doi.org/10.1002/14651858.CD003998.pub3
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10. Rhee TM, Hwang D, Lee JS, Park J, Lee JM. Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1153-1161. https://doi.org/10.1001/jamaoto.2018.2130
11. Joshua TG, Ayub A, Wijesinghe P, Nunez DA. Hyperbaric Oxygen Therapy for Patients With Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2022;148(1):5-11. https://doi.org/10.1001/jamaoto.2021.2685
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