Sudden SNHL (≥30 dB over ≥3 consecutive frequencies within 72 hours) is considered a medical emergency. The first-line treatment according to AAO-HNS guidelines is:

• A Intratympanic gentamicin injection
• B Antiviral therapy with acyclovir
• C Anticoagulation with low molecular weight heparin
• D Systemic corticosteroids (oral prednisolone or IV methylprednisolone) ✓

Explanation

Systemic corticosteroids are the first-line treatment for sudden SNHL, with evidence supporting improved hearing recovery compared to no treatment. Oral prednisolone 1 mg/kg/day (up to 60 mg) for 10–14 days is the standard regimen. Intratympanic steroids are used as primary treatment in patients who cannot tolerate systemic steroids, or as salvage therapy after failed systemic steroids. Antivirals (acyclovir) are not recommended routinely as evidence does not support improved outcomes versus steroids alone.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.